Professional Membership – Developed Country

You have selected a developed country (Annual Membership Fee = USD 145).
Please fill all fields that are applicable. The fields marked with a red asterisk are mandatory. After you complete the application form, you will be automatically redirected to the membership dues payment page

Have you ever created a user account on CRS in the past? *
If yes, please provide your username:
Prefix *
Name Name * First Last
Institution/Company/Organization *

Please provide a complete name of the educational institution. (example: University, College, Training Institute, School)
Designation

Use letters only to enter your designations (example: MD, RN).
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Select one: *

Select one: This is my home address This is my office address This is neither my home address nor office address but i would like all communication to be sent here
Preferred Phone Number *
Email *
What is your most advanced degree? *
Number of years in clinical research *
Please check the one primary box that best represents your primary institutional affiliation. *
If other, please state what best represents your primary institutional affiliation in the box below
Please select the option that best represents your job description *
If other, please state what represents your job description in the text box below.
Choose any two operational areas of your interest
Will you be willing to sit on one of our committees, or be a part of a CRS chapter in your local area.

If you answer is yes, we will contact you regarding our various committees and programs and gauge your interest in becoming an integral part of one or more of them.
Proof of work experience (Optional now)

Attach Files

Please upload an appropriate proof of work experience. One of the following can be used - copy of letter from current or former employer or contracting organization, copy of identity card, copy of business card, or any other document that demonstrates work experience in clinical research. If you don't have one while submitting your application, you may send it to us through an email at membership@clinicalresearchsociety.org within 7 working days from the date of application submission.
Upload your CV (optional)

Attach Files
Disclaimer *

Disclaimer I agree to have provided correct information to the best of my knowledge.