Registration

Step 1

Please select the country that you would like to submit details for

Step 2

First Name

Last Name

Title

Organization

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

Fax

Are you the ESTS Regent for your Country? Yes No

Upload Photo

Please write a brief paragraph about your practice introducing yourself

Step 3

How many Societies represent thoracic surgeons in your country?

Step 4

What is the name of the main Society Representing Thoracic Surgery?

Organization

Home page

Is this Society

Please Select Thoracic only
Thoracic and Vascular
Thoracic and Cardiothoracic
Thoracic and General/Visceral
Cardiothoracic only

How many accredited thoracic surgeons are there in this society?

This is Unknown Approximate Accurate

Please insert the President of this Society

First Name

Last Name

Please insert the General Secretary of this Society

First Name

Last Name

Title

Please provide the following contact information for the administrator for this society

First Name

Last Name

Title

Organization

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

Fax

Step 5

Step 6

Does your country collect information on thoracic surgery procedures in a national database?

Please Select Yes No

What organization supports this activity?

Please insert the thoracic database coordinator's details

First Name

Last Name

Title

Organization

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

Fax

URL

Finish

Enter any other comments you wish to here

EUROPEAN COUNTRIES

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Step 6

Finish