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

                                       STRUCTURED PUBBLICATIONS LIST FORM

               List of the 5 most important publications in the cardiology field, published in per-reviewed journals or journals
               with impact factor


               PUBLICATION 1
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               PUBLICATION 2

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               PUBLICATION 3
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               PUBLICATION 4

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               PUBLICATION 5
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               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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