Membership Step 1 of 4 25% Application for Membership in AEOSAbout youSalutation(Required)Mr.MsTitelYour Personal Information(Required) First Last Your Email Address(Required) Email Address Confirm Email Address Private Address(Required) Street Address Line 2 City ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Your Phone Number ProfessionProfessional Group(Required)specialist physicianassistant physicianstudentType of Institution(Required)HospitalClinicothersInstitution(Required)Position(Required)EFN – Uniform Continuing Education NumberThe EFN is a unique continuing education number assigned to each physician by their regional medical association. The EFN consists of 15 digits and is standardized nationwide (also known as the “barcode number”). By providing your EFN, the continuing education points you collect will automatically be forwarded to the relevant regional medical association. You no longer need to submit them yourself. You have selected the professional group Student and are therefore exempt from the membership fee. Please upload a current enrollment certificate to confirm your membership.Upload Student IDt(Required)Accepted file types: pdf, png, jpg, Max. file size: 2 MB. You have selected the professional group Specialist Physician or Assistant Physician and are therefore subject to a membership fee of 50 EUR annually. General Membership Terms and ConditionsBy signing the membership application, the applicant agrees to the following general terms and data protection regulations and confirms that they have read and understood them. Without this agreement, membership cannot be legally established. Upon joining AEOS, an annual membership fee must be paid: Specialist Physician: €50 Assistant Physician: €50 Students: Free (with proof of current enrollment certificate) Data Protection Agreement I agree that my personal data will be collected, processed, and used in accordance with the Federal Data Protection Act (BDSG) in connection with my membership in AEOS. Without this consent, membership cannot be established. The provided personal data will be used exclusively for association purposes, including: Membership management Announcements of general meetings Information about events As part of the association’s administration, AEOS cooperation partners are also included. If an email address is provided, communication within the association will take place electronically whenever possible. The use of voluntary information can be revoked at any time by informing AEOS. Furthermore, I agree that my name, address, and email address will be included in the membership list, which is available to other members upon request. I also consent to the electronic recording of my personal data. I have read and accepted the statutes of AEOS. I acknowledge the conditions and data protection notices mentioned in this document and agree to them.SEPA Direct Debit Mandate and Consent(Required) I hereby authorize AEOS e.V to collect payments from my bank account via SEPA Direct Debit. I further authorize my bank to debit my account accordingly. I confirm my full consent to these transactions and acknowledge my right to request a refund within eight weeks from the debit date in accordance with my bank’s terms.Account Holder:(Required)IBAN:(Required)BIC:(Required)Bank(Required)Consent(Required) By submitting your data, you consent to AEOS processing your information for the purpose of handling your application, in accordance with our data protection guidelines. Your data will be deleted if you withdraw your consent or upon termination of membership.Subscribe to the AEOS Newsletter Consent to AEOS processing your data for the purpose of sending the membership newsletter, which is published at irregular intervals, as well as other membership-related information to the email address provided by you.