94%
EANM Inflammation & Infection Committee | Application Form
Please note that for your application to be complete, you must
upload your CV at the end of the form.
Questions marked with a
*
are required
First Name
Last Name
Country (work residence)
-- Select --
Armenia
Austria
Azerbaijan
Belgium
Bosnia Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Georgia
Germany
Greece
Hunagry
Iceland
Ireland
Israel
Italy
Latvia
Lithuania
Luxembourg
Malta
Netherlands
North Macedonia
Norway
Poland
Portugal
Romania
Serbia
Slovak Republic
Slovenia
Spain
Sweden
Switzerland
Türkiye
Ukraine
United Kingdom
What is your date of birth?
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
Profession
-- Select --
Basic scientist (e.g Biologist/Biochemist/Physiologist)
Cardiologist
Computer Scientist
Hospital/Medical Departement Manger/Executive
Industry representative
Neurologist
Non-Governmental Organisation
Nuclear Medicine Physician
Oncologist
Other Medical Specialist
Pharmacist
Physicist/Engineer
Radiation Protection Officer
Radiologist
Radiopharmacist/Radiochemist
Radiotherapist (Radiation Oncologist)
Student
Technologist/Nurse/Radiographer
Have you already been involved in EANM activities?
Yes
No
If yes, which one (s)?
How many hours/week can you dedicate to the EANM Committee activities?
Why are you interested in joining this EANM Committee? Max. 200 characters
What are your expectations regarding your role as a member of the Committee? Max. 200 characters
Why would you be a good fit for this Committee? (e.g. Soft Skills) Max. 200 characters
What are your main accomplishments so far? (Residencies, training programs, PhD, clinical experience, success in your profession etc.) Please name 3 personal highlights:
What experience and expertise do you have in infection/inflammation imaging? Max. 200 characters
Please indicate your level of interest with the following criteria:
Very interested
Interested
Not very interested
Not interested at all
Advancing nuclear imaging in inflammatory & infectious disorders
Very interested
Interested
Not very interested
Not interested at all
Collaborating with clinical societies
Very interested
Interested
Not very interested
Not interested at all
Education & training
Very interested
Interested
Not very interested
Not interested at all
Shaping guidelines
Very interested
Interested
Not very interested
Not interested at all
Please indicate your level of experience based on the following criteria:
Expert / Advanced experience
Intermediate knowledge
Basic knowledge
No experience
Not Applicable
Advancing nuclear imaging in inflammatory & infectious disorders
Expert / Advanced experience
Intermediate knowledge
Basic knowledge
No experience
Not Applicable
Collaborating with clinical societies
Expert / Advanced experience
Intermediate knowledge
Basic knowledge
No experience
Not Applicable
Education & training
Expert / Advanced experience
Intermediate knowledge
Basic knowledge
No experience
Not Applicable
Developing guidelines
Expert / Advanced experience
Intermediate knowledge
Basic knowledge
No experience
Not Applicable
Are there any other captivating facts or insights about you? (Project ideas? Who inspires you?) Max. 200 characters
How did you hear about this Open Call?
-- Select --
EANM Website
EANM Newsletter
EANM Invitation E-Mail
LinkedIn
Facebook
Instagram
EANM Volunteer
Other
Start
Save & Continue Later
Powered by
QuestionPro
Loading...
close
drag_indicator
close
Yes
Cancel
Continue
Answer Question
Continue Without Answering
Keep Data
Discard
close