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GLOBALink Membership Application Form
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Title
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Prof.
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In tobacco-control since (year)
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Recommandations
To become Member of GLOBALink, you need to be identified as a Tobacco-Control Professional.
In order to trigger the application process, please list three known advocates who could recommend your Membership to the network (GLOBALink Members would be a plus).
Please give Full Name, Organization, Address, Tel, Fax and email.
First tobacco control Advocate (name, address, telephone)
First tobacco control Advocate (Email address)
Second tobacco control Advocate (name, address, telephone)
Second tobacco control Advocate (Email address)
Third tobacco control Advocate (name, address, telephone)
Third tobacco control Advocate (Email address)
Background
Curriculum Vitae ( )
Degrees in public health / tobacco control
Describe your activities in tobacco-control
Recent publications
Where did you hear about GLOBALink ?
Regular bulletins
GLOBALink Today
No bulletin
Daily index
Medical Journal Update
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Periodic bulletin
NIMI (English)
No bulletin
Regular index
Regular bulletin
Submission
I agree to the terms & conditions of GLOBALink, and I hereby certify that I am in no way affiliated with the tobacco industry, either directly or indirectly, and furthermore certify that I do not envisage any future affiliation with the tobacco industry.
TreaTobacco
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