Herewith request to be admitted to be the ordinary member of the Asian Society of Cryosurgery (ASC). I also vow to comply with the statutes of ASC and to observe all its rules and regulation as well as the decisions ASC may adopt.
I hereby attach my personal curriculum vitae along with this application form.
*Note: All personal information provided to ASC will be retained by the Society as required by laws. It will be kept private and confidential and will not be shared with any third party without your consent.