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European Hormone Medal Nomination Form

Please complete the fields below
Please tick the box below if this is a self-nomination If so, please provide a letter of support from 2 ESE members below
Self-nominations only
Self-nominations only

The data that you submit via this form will be used in order to record and process the award nomination including providing details to the relevant ESE jury for deliberation.
Your data will be made available to ESE, the jury for the award and our congress organiser. The data that you submit via this form will be stored securely in accordance with ESE’s Privacy Policy and will not be shared with any third parties. Your data will be fully accessible upon request and you can unsubscribe from the mailing list at any time by emailing info@ese-hormones.org. Please confirm you have read and agree to the above data policy.

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