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Application to join the ANHEPR

Last name:

First name(s):

Preferred first name:

Title:

Position:

Work Address:

Postcode

Phone:

Fax:

E-mail:

Website (if applicable):

Summary of specific research interests/policy topics being pursued:

Brief statement of current research/policy related activities (note source of support where applicable):

Summary of other professional functions (e.g., work for professional bodies, journal editorships, consultancies and the like):

Up to five recent major publications (These would include official reports. Please list these starting with the most recent. If more than 5 are named, only the first 5 will be listed in the Directory):