Application for the IAC International Board of Cytopathology Examination

For this form you will require:

• Information about your medical degree and specialist training
• To be uploaded:
  • A copy of your current CV indicating your medical education, specialist certification and current employment. Publications are not necessary.
  • A passport sized photograph (250 x 300 pixel). Please do not scan your passport or identification card.
• The CONTINUE BUTTON is bottom right.
• The application fee is Euro 450 and can be paid on-line using a credit card, Applepay or Paypal. If your application is not approved the payment can be refunded.
• Application for IAC International Board of Cytopathology Examination

  Payment can be refunded if you are unable to attend.

  "*" indicates required fields

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  Personal Information

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  Date

  MM slash DD slash YYYY

  Your Given Name*

  Given Name

  Your Family Name*

  Family Name

  Your six digit membership number*

  Your email*

  Please enter your contact email

  Phone*

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  The examinations are planned together with national cytology societies. Below is the list of currently planned examination sites.

  I would like to sit the exam in:*

  23. June 2024 Leipzig Germany

  Has your address changed recently?*

  Yes

  No

  Where shall we send IAC postal correspondence?

  If you enter your work address, please include department name and institute name.

  Address Line 1*

  Address Line 2

  Address Line 3

  City / Town*

  Postal Code

  (If required) State / Region /Province

  Not every address requires a state

  Country*

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  I am a certifiied specialist in my country of residence*

  Yes

  No

  Please explain the qualification situation and regulations in your country*

  I passed my specialist exam in (subject)*

  Year*

  Please upload a current copy of your CV*

  Your current employment should be indicated.

  Drop files here or Select files

  Accepted file types: pdf, jpg, png, Max. file size: 35 MB.

  Please upload a passport sized photograph*

  Please do not upload a copy of your passport.

  Accepted file types: jpg, png, pdf, Max. file size: 35 MB.

  After submitting you will be lead to the payment page. Payment can be refunded if you are unable to attend.

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