ANZCNS Registration

Associate Membership

Any person who expresses a desire to contribute to, participate in, or assist the Society achieve its objects (as set out above and in the ANZCNS constitution) may be invited or apply to join the ANZCNS as an Associate Member.

Costs below include Payment Processing Fee $2.18 applied to all credit card transactions

Price:

$107.18 for access until 30 June 2023

First Name:* First Name Required

Last Name:* Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Mobile Number:* Mobile Number is Required

Q1 - What is/are the name/s of your current institutions?: Q1 - What is/are the name/s of your current institutions? is not valid

Q2 - What is/are your current role/s?: Q2 - What is/are your current role/s? is not valid

Q3 - What is your current FTE in clinical practice related to paediatric neurology?: Q3 - What is your current FTE in clinical practice related to paediatric neurology? is not valid

Q4 - What is your current FTE in research related to paediatric neurology?: Q4 - What is your current FTE in research related to paediatric neurology? is not valid

Username:* Invalid Username

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Password Strength Password must be "Very Strong" or stronger

Description	Amount
Associate – Payment	$107.18
Total	$107.18

ANZCNS

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