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ESC F.E.S.C. Application Deadline: 15 MAY 2003
EUROPEAN
SOCIETY OF
CARDIOLOGY

STRUCTURED CURRICULUM VITAE FORM

ACADEMIC EDUCATION
YEARS UNIVERSITY FACULTY
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PROFESSIONAL EXPERIENCES
YEARS INSTITUTION POSITION

PRESENT POSITION
YEARS INSTITUTION POSITION

DATE: …………………………………………………………… SIGNATUREOFTHEAPPLICANT: ……………………………………………………………………

Please retum application and documentation before 15 Mav 2003. to the European Society of Cardiology,
National Society 8 Member Relations Dept., 2035 route des Colles, B.P. 1 7g, FR 06903 Sophia-Antipolis, France
You trave personal data which is, according to the Law on data process/ng and C/v/l Liberties 78-17 of 6 Januarg1978, registered with the ESC. You trave
the absolute right to acces* amena and oppose any use of this personal data by contacting (in writing) the ESC National Soc/ety and Member Relat/ons at
the address ment/oned acove. Unless otherw/se /nformed, the ESC may sena you /nformat/on about /ts acUvffles from Ume to t/me.

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