The Bangladesh Society of Ultrasonography

MEMBERSHIP APPLICATION FORM

Type of Membership applying for: *
Associate Member General Member Life Member

Name:

Mailing Address:

Phone:

E-mail:

Institution:

Institution Phone:

Chamber:

Camber Phone:

Education

Primary areas of Ultrasound Expertise:

Experience in Ultrasound:

Publications in Ultrasound or
related Subjects:

Year of Membership in B.S.U:
Associate Member General Member

Proposer's Name:

Seconder's Name:

Recommendation of the Membership Committee:

Decision of the Executive Body: