Membership Application Form

If you would like to become a Member of the International Federation for Emergency Medicine please complete the application form below.

Before completing the application form please review the Membership Application Criteria.

The Membership application fee is equivalent to one year membership fee. Once your Membership is successful you can pay this fee using our online payment form.

If you have any questions please don’t hesitate to contact us.

Membership Application Form

A) Organisation Contact Information
Registered Name of Organisation*
Organisation Mailing Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Organisation Email*
Organisation Phone Number including country code*
Organisation Website*
B) About your Organisation
What year was your organisation established?*
Is there a charter / by-laws reflecting its goals?*
Name of current President*
How many members does your organisation have?*
What member categories does the organisation have?*
Does your organisation have non-physician members?*
If yes, please describe
History of your organisation*
C) About Emergency Medicine in your country (NA for Ex-Officio applications)
Is Emergency Medicine recognised as a medical specialty in your country?*
Are there other organisations representing emergency physicians in your country?*
If yes please provide details*
Does a recognized physician training program exist in your country?*
If yes which organisation is responsible for running the program?
D) Details of the person who will represent your organisation in IFEM matters if your application is successful
Representative name*
Position in organisation*
Representative Mailing Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Representative Email
E) Supporting documentation and declaration
Representative Phone Number including country code*
Web address of by-laws or attach below
Attach copy of by-laws or charter
Attach any other relevant documentation
Drop files here or
I confirm that all information given is correct at the time of completing this application form
Your name*
First Last

Username
Password

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If you would like to become a Member of the International Federation for Emergency Medicine please complete the application form below.

Membership Application Form

A) Organisation Contact Information

B) About your Organisation

C) About Emergency Medicine in your country (NA for Ex-Officio applications)

D) Details of the person who will represent your organisation in IFEM matters if your application is successful

E) Supporting documentation and declaration

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