Emerging Anti-Microbial Resistance Society (EARS)        EARS MEMBERSHIP IS FREE.

Registration Form

* marked fields are mandatory.
Basic Information
Title
Full Name *
Age   (Numeric Only)
Sex Male    Female
Date of Birth    (Format: dd/mm/yyyy or dd-mm-yyyy)
Residential Address
Office Address
City
State
Country
Zip Code
Email ID *     (example@domain.com)
Phone No.
Cell Phone
Fax
Professional Information
I am currently * :  
Speciality * :  
Name of (Hospital/Self Employed Clinic Name/CRO/Research Center) * :
Professional Experience :
Academic Qualification * :  
Areas of Interest * :  
Your practice is * :  
Comments * :
 
  Upload Data and Sharing
       (This section is especially for hospitals and labs to create user accounts for data entry of sensitivity/resistance.)
 
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