WMA JDN Membership Application Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Dear Colleague,

Please kindly fill out this form in order to facilitate your joining the Junior Doctors Network (JDN). Data will only be used for the World Medical Association (WMA) and JDN affairs and will not be shared with 3rd parties without your permission.

Important: Remember that to apply for the JDN, you first need to be register and be accepted as WMA member. If you haven't applied yet, you can register as WMA member here: https://bit.ly/3CBpHze

Please ensure to fill the form correctly as false information may lead to immediate cancellation of membership and escalation to relevant authorities.

Looking forward to welcome you to the JDN!

Personal Details

Name in full *

Gender *

Female

Male

Prefer not to say

Other:

Nationality

Country of Residence *

Email Address *

Phone number (with Country code) *

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms