WADD
New Member Application Form

Membership period is for one year
Personal Details  
The fields marked REQ are obligatory, and must be completed before continuing to the next page.

Title
Degree
First Name
Last Name
Year of Birth
Organization/Institution
Address
 
City/Town
State/Province
Postal code
Country
Telephone
Email
Registration
Registration Details
   Fee $
Member of WADD Annual Fee 25.00
Other Affiliations
If you are affiliated to some Local Psychiatric Society in your Country, please type below:
Affiliated to this Local Society
= Required field
  Secretariat
  World Association of Dual Disorders. Londres, 17 - 28028 Madrid. Espaņa.
  Tel. +34 91 3612600 - Fax: +34 91 3559208
  email: secretariat@worlddualdisorders.org