ATSR Membership

Test en cours
(les cases informations sont des champs email et doivent être corrigé avec la version booster
limite actuelle d'ajout de champs

ATSR Membership Application Form

I, the undersigned),

First name

Surname

Application to join the Association for Radiation Protection Techniques and Sciences (ATSR) as:

your choice :

Membre actif

Membre bienfaiteur

Membre adhérent

J'agis pour le compte de

Specify the name of your company/business if you are acting on behalf of

I became aware of theamount of membership* for the year 2023, which is €32 for active members and adherents, free for students** and for retirees who wish expressly receive thereview.

* Membership includes subscription to the ATSR journal

** Please send us with your check a copy of your student card

The payment will be made by check in the name of the ATSR

your choice:

Sent to the address of the General Secretariat (Mme Sandra VILLAGE, 141 rue du Jura 01170 CROZET)

through my regional representative

Personal information :

Address :

Postal code :

City :

E-mail

Phone

Personal training(s):

specialty in radiation protection:

I agree to transmit this information to the ATSR

Thank you for your interest in our association.

Your request membership en ligne at the ATSR will be sent to our secretariat.

Your membership will be effective upon receipt of your contribution check.

ATSR Membership

Test en cours (les cases informations sont des champs email et doivent être corrigé avec la version booster limite actuelle d'ajout de champs

ATSR Membership Application Form

Test en cours
(les cases informations sont des champs email et doivent être corrigé avec la version booster
limite actuelle d'ajout de champs