The Egyptian Society of Internal Medicine                                    

5 El-Gomhria St., Abdeen, Cairo- Egypt

Registration Form

To participate , you should fill out the following form and click submit to mail us.

(Note :  All Field with * should be completed  before submitting the form  )

1. Please submit or download the form and  fax to (202)3914575 .
2. Deposit 50 LE  Egyptian National Bank ( El-Nasr branch) Talat Harab st.,  account No. 0100500948 Routing No. 0000000000000. You  can pay in or cash at the society suite .
3. Fax receit copy to  (202)3914575
4. You will receive E-mail to come the society suite to get your membership ID & your certificate 

You can download the form just click on this link regform.doc