FESGE Application form – ESGE Applications

Personal information

ESGE Membership ID*

Current uninterrupted membership in ESGE for a period of no less than five years (post Trainee Membership) is required.

Medical Degree*

for example: MD, PhD

Full name*

First Middle Last

Email*

Enter Email Confirm Email

Postal address*

To be used for shipment of the pin and a certificate

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Significant contributions to GI endoscopy as evidenced by one or more of the following

Your scientific and educational contribution to the field of GI endoscopy*

Please describe below or insert N/A if not applicable

Your past and ongoing involvement in ESGE activities*

Please list below, including the name of Committee and / or Working Group and / or Activity, the date of service, and your role. Please insert insert N/A if not applicable.

Do you hold any leadership position within a medical society, other than ESGE?*

No
Yes

If yes please provide details below*

Documentation

All submitted documents must be in English

Current brief CV with list of publications*

Please include your brief CV with list of publications (1 file, up to 5 pages, PDF format, maximum file size: 2 Mb)

Accepted file types: pdf, Max. file size: 2 MB.

1. Recommendation letter from a current FESGE member*

Please include the recommendation letter No 1. from another FESGE member. (Up to 500 words, 12-point font format: PDF format, maximum file size: 1MB)

Accepted file types: pdf, Max. file size: 1 MB.

2. Recommendation letter from a current FESGE member*

Please include the recommendation letter No 2. from another FESGE member. (Up to 500 words, 12-point font format: PDF format, maximum file size: 1MB)

Accepted file types: pdf, Max. file size: 1 MB.

Application fee of €295*

On approval of my application I agree to settle the one-time fee of €295, within two weeks from receiving an invoice.

Billing address

Please provide your billing address if it is different from the postal one inserted above.

Consent*

Please read and agree to the ESGE Privacy Policy terms and conditions before submitting your application

I have read the ESGE Privacy Policy and agree to its terms & conditions.

Comments

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

Fellow of ESGE (FESGE) Application form

Personal information

Significant contributions to GI endoscopy as evidenced by one or more of the following

Documentation