Membership Application

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Membership Application

Please fill out the following information and submit it, and your membership will then be completed after due screening and approval by the board of directors.

Private(not visible in profile)

* Required Fields

Full Name *

Gender *

Male

Female

Date of Birth *

Your Profession *

Physician

nurse

nurse practitioner

pharmacist

social worker

physical and occupational therapist

medical technologist

paramedic

other home care worker

Other:

Required

Registration No. (only if applicable)

Name of your organisation(English) *

Name of your organisation(Korean, if applicable)

Email *

Mobile *

I agree to pay annual subscription fees *

Yes

I have read the Privacy Policy and grand consent to use my data *

Yes

Please tick if you want to receive text messages from us about any news

(You can refuse to receive SMS, but if you refuse, you will not be able to receive SMS from us.)

Yes

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