ESGO Professional Recognition of Gynaecological Oncologists

INTEREST FORM

Dear ESGO Members,

we would like to thank you for expressing your interest in the ''ESGO Professional Recognition of Gynaecological Oncologists'' certificate.
This questionnaire is the first step in the application process; accordingly, we will send you the necessary application forms this fall.

Thank you for your time and interest in applying.

ESGO Training Committee

Please complete all required fields in this questionnaire.

Question Title

* 1. Your full name

Mr./Ms.

First Name

Middle Name

Last Name

Question Title

* 2. Your affiliation:

Hospital/ University/ Research or Medical Institute/ other:

Name:

Address:

Question Title

* 3. Number of years you have been a member of ESGO:

1 year - 4 years

5 - 10 years

more than 10 years

Question Title

* 4. Your age group:

under 40

40-49

50 -59

over 60

Question Title

* 5. How long have you been a surgeon in the field of Gynaecological Oncology?

10- 15 years

Less than 10 years

More than 15 years

ESGO Professional Recognition of Gynaecological Oncologists

INTEREST FORM

Question Title

* 1. Your full name

Question Title

* 2. Your affiliation:

Question Title

* 3. Number of years you have been a member of ESGO:

Question Title

* 4. Your age group:

Question Title

* 5. How long have you been a surgeon in the field of Gynaecological Oncology?

Question Title

* 6. Your Contact details for the application.email:

* 6. Your Contact details for the application.

email: