ESTRO Corporate Membership

Application for 2019

Rate:3000 Euro (excl. VAT)

  1. General information

Please fill in the table below.

Legal Company name
Address
Phone / Fax
Company website
CEO / Email
Marketing Director / Email
Other contact name + title / Email
  1. Invoicing information

Please fill in the table below.

Invoicing Address (if different from above)
Account manager/contact accounting / Email
PO number (if applicable)
VAT number
  1. Individual corporate membership

Please register below the 3 people eligible for individual Corporate membership. (** see benefits at the end of this document)

Cost for additional Individual Corporate member: 55€/each (excl. VAT)

ESTRO privacy notice

**In the light of the new GDPR regulations, ESTRO has updated its privacy notice. Please carefully read our privacy statement here and specify that you agree in order to be registered as a member.You will be able to update your contact details or unsubscribe at any time through your account page: ESTRO will keep your personal data on record for 2 years after the end of your last membership registration and under no circumstances will share your details to third parties without your prior consent. Should you wish to delete your record, kindly contact the ESTRO Office by email

Name (first + last):
Position:
Specialty (please select):
□Administrator
□Marketing - Sales
□Communication
□Physicist
□Engineer
□IT
□Research and development
□Manufacturer
□Other
Mailing address:
Tel:
Fax:
E-mail
In my quality of ESTRO member, I agree with the ESTRO privacy notice**: yes – no (please select)
Name (first + last):
Position:
Specialty (please select):
□Administrator
□Marketing - Sales
□Communication
□Physicist
□Engineer
□IT
□Research and development
□Manufacturer
□Other
Mailing address:
Tel:
Fax:
E-mail
In my quality of ESTRO member, I agree with the ESTRO privacy notice**: yes – no (please select)
Name (first + last):
Position:
Specialty (please select):
□Administrator
□Marketing - Sales
□Communication
□Physicist
□Engineer
□IT
□Research and development
□Manufacturer
□Other
Mailing address:
Tel:
Fax:
E-mail
In my quality of ESTRO member, I agree with the ESTRO privacy notice**: yes – no (please select)
  1. Company specialty

Please check all that applies.

□Accelerator
□Brachytherapy
□Dosimetry / Detectors
□Imaging
□Technology
□Medical device
□Patient handling / Positioning
□Pharmaceutical / □Practice management
□Professional Society
□Quality Assurance
□Radioisotope Source
□Manufacturer
□Treatment delivery systems
□Treatment planning
□Other (please specify):
Principle RO product / service

BENEFITS for 2019

  1. General
  1. Visibility in Corporate members directory on the ESTRO website.
  2. Visibility in the ESTRO annual report.
  3. Three complimentary Individual Corporate memberships (** see benefits at the end of this document).
  4. Corporate members’ emblem use (upon request and ESTRO’s approval).
  1. ESTRO congresses and meetings(excl. joint events)
  1. Priority to book exhibit space, advertising, sponsoring and satellite symposia related to ESTRO conferences advance of non-members companies. In case of duplicated requests, priority will be given on a first-come first-served basis.
  2. During ESTRO conferences, you are entitled to 1 complimentary full exhibitor badge (including access to the exhibition hall and scientific sessions) + 2 complimentary regular exhibitor badges (access to the exhibition hall) per 9 sqm booth space rented.
  3. Preferential fee on company exhibitors’ badges during conferences.
  4. Corporate member acknowledgement in conference programme book.
  1. ESTRO AnnualCongress

In addition to the benefits stipulated in point b.:

  1. Recognition as corporate member in exhibitors list.
  2. 5% discount on advertising and sponsoring.
  3. Possibility of personal appointment to collect exhibitors’ badges.
  1. ESTRO Teaching courses
  1. Preferential registration fee for exhibitors taking part to ESTRO teaching courses: company delegates will benefit from an early member registration fee for teaching courses.
  1. Benefits related to the Individual Corporate membership (Corporate representatives)
  1. Subscription and online access to Radiotherapy and Oncology (electronic only)
  2. Discount on the article publication charge related to the open access journals (ctRO, phiRO, tipsRO)
  3. Discounted online subscription to the AAPM publication Medical Physics*
  4. Reduced registration fee for attending one ESTRO conference or one teaching course ONCE A YEAR (includes joint courses and conferences)
  5. Special prices for ESTRO Publications and Handbooks
  6. Online access to the ESTRO Physics Booklets
  7. Online access to the ESTRO EU Affairs Monitoring Report
  8. Access to the monthly ESTRO Public Affairs e-newsletter upon request

* Medical Physics: ESTRO members should contact Wiley, identify themselves as current ESTRO member, and ask for the discounted online-only subscription.

The price is as follows:
· USD $70
· GBP £47
· EURO €64

The European customer service contact information is as follows:
Tel: +44 (0)1865 778315
Email:

If the member is located in Germany, Austria, Switzerland, Luxembourg or Liechtenstein please contact:
Phone: 0800 1800 536 (From Germany)
Phone: +44 (0)1865476721 (Outside Germany)
E-Mail:

Wiley US:
Tel: +1 781 388 8598
Tel (toll free): +1 800 835 6770
Email:

Wiley Asia Pacific English language service:
Tel: +65 6511 8000
Email:

Japaneselanguageservice:
Email:

Please return this form with copy of payment proof to:

ESTRO Office, Rue Martin V, 40 - 1200 Brussels - Belgium

Tel +32.2.775.93.41 – Fax +32.2.779.54.94

Web:

Do not forget to make a copy for your own record