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Application for acceptance into the DOG

Please download the application document:
[PDF] as well as the authorized automatic withdrawal form [PDF].

Hereby, I apply for the membership into the DOG / the German Ophthalmological Society.

Ms.Mrs.Mr.



Addresses
Institution Address


















Private Address








Address to be used*

institutionprivate
institutionprivate
institutionprivateno entry at all

Certification / Residency*

OphthalmologistOphthalmologistResidentScientist working in visual researchOthers


Magazine subscription

Please note:

Your application can only be processed, if you designate two references, who should be members of the German Ophthalmological Society, as well.

1st reference*

2nd reference*