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Registration for Membership

First name*:
Last name*:
E-mail address*:
Gender*:	--------- Mr. Mrs.
Title:	--------- Prof. Dr.
Street*:
Street nr*:
Postal code*:
City*:
Function / Department:
Company:
Newsletter:
Password*:
Password (again)*:

*these fields are required

For physicians: Please also visit www.sgpm.ch if you would also like to apply for SGPM membership. The reduced SwAPP double membership fee will be applied automatically.