IAC Profession Non-Medical membership application form | The International Academy of Cytology

For this form you will require:

A copy of your Masters degree and any other specialist training and experience in the field of cytology
A short copy of your CV indicating your training and experience in cytopathology
Your publications of the last four years only
A small photograph for internal purposes only.
Applications also require a sponsor who is an IAC member.

The names of accepted members are added to the IAC list of active members In the IAC members area.

Personal Information

Hidden

Date

Your Given Name*

Given Name

Your Family Name*

Family Name

Your date of birth*

Please enter your date of birth beginning day/month/year

Your email*

Please enter your contact email

Phone*

Where shall we send your journal and IAC postal correspondence?

Please enter a full postal address. If your work address please include the department.

Please do not try to fit your address on one line.

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*

Your professional information

Your current position*

Current Employer*

Name of employer

Your work address, if Hospital or Medical Center include name of institute and department*

Your degree and training

Name of your degree*

Please let us know what field you attained your degree in.

I attained my degree (Year)*

Name and address of School / University / Institute*

Where do you achieve your degree?

Interest in Cytology

Training in Cytopathology or Clinical Cytology*

Please include dates as well as the names of University/Hospital/Institute. and address and your activities. (Full-time only)

Required documents

Please upload a copy of your degree*

Accepted file types: pdf, jpg, png, Max. file size: 146 MB.

Your resume should clearly indicate any training and experience in cytopathology or clinical cytology

Please upload a copy of your CV*

Drop files here or

Accepted file types: pdf, jpg, png, Max. file size: 146 MB.

Publications (last four years only)

Drop files here or

Accepted file types: pdf, jpg, png, Max. file size: 146 MB.

Please upload a passport sized photograph. (Headshot)*

This picture will not be published and is for internal reference only.

Accepted file types: jpg, gif, pnd, pdf, Max. file size: 146 MB.

Phone

This field is for validation purposes and should be left unchanged.

Personal Information

Where shall we send your journal and IAC postal correspondence?

Sponsors

Your professional information

Your degree and training

Interest in Cytology

Required documents