Become Our Member – Georgian Pharmacy Association

Name
Surname
Fathers’ Name
Birth Place
Birth Data
ID Number
Address of Residence
Number (Home)
Number (Mobile)
E-mail
Which college you graduated from (or are you studying currently) and when?
Specialty
Professional Association and Community Membership, Including international organizations
Name of the Association Status Dates
Information about public activities
Government Awards
The honorary title
More information about me:
*
I agree to the privacy policy.
I am responsible for the accuracy of the information stated in the application.
I have read, acknowledge and agree regulations of Georgian Pharmacists Association and a code of ethics for pharmacists.

With my signature I agree to become a member of Georgian Pharmacists Association:

Name of the Association	Status	Dates

Professional Association and Community Membership, Including international organizations