EUSPR Membership form

[contact-form to=’omarcabrita@gmail.com’ subject=’EUSPR membership application’][contact-field label=’I wish to join the EUSPR’ type=’checkbox’ required=’1’/][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’Title’ type=’text’/][contact-field label=’Please tick the profile box which best matches your position/role:’ type=’radio’ options=’Practitioner,Professor,Researcher,Student’/][contact-field label=’Other profile (please specify)’ type=’text’/][contact-field label=’Do you wish to join the Early Careers Forum within the EUSPR? Web link: https://euspr.org/early-careers-forum/’ type=’radio’ options=’Yes,No,Already joined the forum’/][contact-field label=’When did you first enter the prevention field (e.g. employment or commencement of doctoral studies)? Please state the year:’ type=’text’/][contact-field label=’Position/Role’ type=’text’/][contact-field label=’Organization or Institution’ type=’text’/][contact-field label=’Address’ type=’text’/][contact-field label=’City’ type=’text’/][contact-field label=’Postal Code’ type=’text’/][contact-field label=’Country’ type=’text’/][contact-field label=’Telephone (country code – city code- number)’ type=’text’/][contact-field label=’Fax (country code – city code- number)’ type=’text’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Date on which you arranged payment of fees via bank transfer:’ type=’text’/][contact-field label=’In point form, please describe your area of expertise (required):’ type=’textarea’ required=’1’/][/contact-form]