Australasia Paediatric Endocrine Group (APEG) > Membership > Application for Membership

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Application for Membership

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First Name:	*
Last Name:	*
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Is this your personal address? Yes
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Please provide us with the 2 person that had nominated you: We will require both full name and email address of the nominator as shown below.
1st Nominator:	* example: John Smith, john@somewhere.com
2nd Nominator:	* example: John Smith, john@somewhere.com

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