EAS Membership Application Form

Name (First, Middle, Last)
Country
Address: Institutional Address (University, Hospital, Clinic etc.)
Department, Institute, University, Hospital
PO Box
Street and Number
Postal Code
City
Country
I would prefer to have EAS mail sent to my home address (optional home address):
Street and Number
PO Box
Postal Code
City
State or Region
Country
Year of birth
Sex	Female Male
Email Address
2nd Email Address
Scientific fields or areas of interest (you may choose more than one):
arterial wall metabolic syndrome nutrition epidemiology lipoprotein metabolism diabetes Wire-O prevention of CVD genetics inflammation coronary artery disease cell biology thrombosis Other, please describe:
Current Position:
PhD Student Post doctoral Position Practicing Clinician Academic Research Scientist University Professor Other (please describe your position below):
Please list your areas of training and career path: (for example; MD Internal medicine, specialization in cardiology, PhD in… etc.)

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Address: European Atherosclerosis Society Executive Office, Altonagatan 7, SE 211 38 Malmö, Sweden
Tel: +46 40 240 750, Fax: +46 40 240 751, E-mail: eas.soc@telia.com
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