New Delegates

Apply to become a delegate by using the form below:

*Title

*First Name

*Last Name

*Nation

*City

*Email

Alternate Email

*UEMS OMFS Group

*Nature of Role

*Mobile phone (including nation code with + first)

Letter of Authorisation

*Email contact at national organisation

*Terms and Privacy Policy

I have read and agree to the terms and conditions and privacy policy

Please only enter your email here if you are not a real person.

Please enter your phone number here if you are a robot.

When you're ready to send the form, uncheck this box and continue. This helps keep our forms secure. Please uncheck this box to continue