Registration

Membership Application Form

Please fill in all the fields that are marked with an asterisk.

*Given Name
Family Name
*Gender	MaleFemale
*Highest qualification earned
*Region
Date of Birth	//
*Specialization
Personal homepage
Attach CV
*Member type	Member US$60Student member US$20
*Information	I agree to having my name listed on the APSCE web page (The information will be displayed after the payment is completed).YesNo
*Password
*email as the account
*Institution name
*Postal address
Zip Code
*Telephone
Fax
The information that I have provided above is true and correct. I confirm that I subscribe to the objectives of APSCE and will be bound by its Constitution.