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4251960-8382000EAN Scientific Panels Individual Panel Membership application 2020Please complete and return to:EAN Head Office Breite Gasse 4 / 7 1070 Vienna AUSTRIA Fax: 0043 1 889 05 03 13 or Email: scientific@Title:First name:Last name:Institution:Department:Street:Postal code:City:Country:Phone:Email:Profession:? I am already member of the EAN Scientific Panel:I wish to become member of the EAN Scientific Panel:?ALS and frontotemporal dementia?Autonomic nervous system disorders?Child neurology?Clinical neurophysiology?Coma and chronic disorders of consciousness?Dementia and cognitive disorders?Epilepsy?Headache?Higher cortical functions?Infectious diseases?Movement disorders?Multiple sclerosis?Muscle disorders?Neurocritical care?Neuroepidemiology?Neurogenetics?Neuroimaging?Neuroimmunology?Neuro-oncology?Neuro-ophthalmology and -otology?Neuropathies?Neurorehabilitation? Neuroscience/ Translational neurology ?Neurosonology? Neurotraumatology?Pain?Palliative care ?Sleep-wake disorders?StrokeI am interested in (please advise on your field/s of interest)? Suggesting educational and congress activities?Production of guidelines?Production of general statements on scientific and clinical issues if needed?Contributing to the collection of data regarding neurological care across Europe and its harmonization?Helping to organize research networks in Europe whenever possible?Producing a forum for information within the focus of the panel ?Other EAN Individual membership? I am already Full, Resident or Corresponding Individual member of the EAN?I apply for Full, Resident or Corresponding Individual membership of the EAN. Further information can be found here.Please do not hesitate to contact our Head Office for more information at membership@. Documents attached:?Summary CV, list of publications DateSignature ................
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