1 Your society 2 President 3 Secretary 4 Main contact 5 Additional contacts 6 Complete Please complete all required sections below (in English) to enable us to process your application Society name * Date society set up * Day12345678910111213141516171819202122232425262728293031 Day MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Year19741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050205120522053205420552056205720582059206020612062206320642065206620672068206920702071207220732074 Year Aims and objectives of society * Number of members (2025) Who is your Society's Governing Body, e.g. a Council, An Executive Committee? How many members are on this Governing Body? * ESE Advocacy Representation Scheme (EARS) As part of your application to become an Affiliated Society a National Partner Society a contribution of €2.50 per member is payable to join the ESE Advocacy Representation Scheme – see the website for full details about EARS here. Becoming part of the EARS Community is at no cost to the members of the national affiliated societies National Partner Societies represented by the ESE Council of Affiliated Societies (ECAS), as the small annual fee of €2.50 will be paid on their behalf by their National Society. Please note that this is separate to any existing ESE membership. This contribution will help support ESE’s Policy and Advocacy work on behalf of all our members. EARS invoicing details VAT/tax number * Invoice contact name * Street Address * City * Postal Code Country * AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCarribean Netherlands - Bonaire, Sint Eustatius and Saba (Netherlands Special Municipalities)Cayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo, Republic of theCongo, The Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d’IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSerbia and MontenegroSeychellesSierra LeoneSingaporeSint Maarten (Constituent Country of the Netherlands)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouthern SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands State/Province Society general email * Society phone number * Society website URL * Why is your Society interested in applying for National Partner Society Membership? * Constitution * Upload Please provide a copy of your Society's Constitution (in English language) More informationFiles must be less than 2 MB. Allowed file types: pdf doc docx. Meetings - frequency, number of delegates * Newsletter – frequency * Other activities (please list) * Privacy policy The data that you submit via this form will be used in order to record and process the application and to deliver services and products. Your data will be made available to ESE in order to approve your application. The data that you submit via this form will be stored securely in accordance with ESE’s Privacy Policy and will not be shared with any third parties unless you have opted in to receive industry news from the Society's Corporate Partners. Your data will be fully accessible upon request and you can unsubscribe from the mailing list at any time. Please confirm you have read and agree to the above data policy * I have read, understand and agree to ESE’s privacy policy Leave this field blank Next Page >