BTG Membership Application – SIOPe Brain Tumour Group

To apply for membership please complete all questions

Name

First

Last

Professional e-mail address

Age

Profession

Working instiution

Country

Experience/ interest in pediatric neurooncology

Role within the pediatric neurooncology network in your country

network group Include

Include reommendations from two SIOPE BTG members (short paragraph)

Choice of working group or discipline group

Why do you want to join this group?