INDIVIDUAL MEMBERSHIP APPLICATION FORM An Individual Member of the European Pharmaceutical Students’ Association is any full time student of Pharmacy or graduates up to two years after graduating within the geographical entity of Europe. The Individual Membership Fee is established according to the Annual World Bank List of Economies and its classification of High Income, Upper Middle Income, Lower Middle Income and Low Income countries according to the countries' Gross National Income (GNI) per capita.
I, the undersigned, declare to become an Individual Member of European Pharmaceutical Students’ Association (EPSA) and will pay the fee of: 25 € for one year / 40 € for 2 years (Lower Middle Income Countries 1) 30 € for one year / 50 € for 2 years (Upper Middle Income Countries 2) 35 € for one year / 60 € for 2 years (High Income Countries3) As an Individual Member I shall: • Receive a copy of each edition of the EPSA Newsletter at the address given at the moment of registration; • Be added in EPSA News e-group; • Receive information about EPSA activities and official calls; • Receive the minutes from the General Assembly; • Have the right to participate in all EPSA projects and events; • Have the right to be present at the General Assemblies;
Name Address (used for sending the publications)
City E-mail
Country Mobile
University
Year of studies
Signature: ____________________________________________
Date:
The money should be transferred to the following account after you have contacted the Vice President of Internal Affairs and they let you know whether your application was approved by the Executive or not:
Account Number: 001-6372217-72 Account Beneficiary: E.P.S.A. Bank: BNP Paribas Fortis, Montagne du Parc 3, 1000 Brussels, Belgium BIC/SWIFT: GEBABEBBXXX IBAN: BE38 0016 3722 1772
In case you have questions or problems, please do not hesitate to contact the EPSA Vice President of Internal Affairs (
[email protected]) or the EPSA Treasurer (
[email protected]).
Ranking of European Countries Gross National Income (GNI) per capita 1 – Lower Middle Income Countries: Albania, Armenia, Azerbaijan, Georgia, Kosovo, Moldova, Ukraine. 2 – Upper Middle Income Countries: Belarus, Bosnia and Herzegovina, Bulgaria, Kazakhstan, Macedonia, Montenegro, Romania, Russia, Serbia, Turkey. 3 – High Income Countries: Andorra, Austria, Belgium, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Monaco, the Netherlands, Norway, Poland, Portugal, San Marino, Slovakia, Slovenia, Spain, Sweden, Switzerland, United Kingdom, Vatican City.
