The candidate should show his/her interest in the field by having at least two publications related to activities in reproductive immunology.

Graduate student and postdoctoral fellows (need to be sponsored by their mentor - ordinary member of the AASIR or sponsored by two ordinary members).

Name: _______________________________________ Title/position: ________________________

Institution: _________________________________________________________________________

Address: _____________________________________________________________________________

______________________________________________________________________________________

Phone: ___________________________________ Fax: ______________________________________

E-mail: ______________________________________________________________________________

Signature: _______________________________ Date: _____________________________________

Two ordinary members of the Society who are willing to support the application and to confirm that the applicant has an active interest in the field of reproductive immunology:

SPONSOR 1 / MENTOR:

Signature:

Date:

SPONSOR 2:

Signature:

Date:

The candidate must include a curriculum vitae with this application form.

Please submit application to
Andrea Lenzi, Secretary - General to AASIR
University of Rome "La Sapienza", Faculty of Medicine,
Department of Medical Physiopathology, School of Andrology,
Policlinico Umberto I, 00161 Rome, Italy
Phone: +39 +6 446 9663; Fax: +39 +6 440 2671