Application Form - GBS Research Connect

Email Address ^*

First Name ^*

Last Name ^*

Honorific

(Mr., Mrs., Ms., Dr., Prof., etc.)

About you ^*

Please tell us about yourself, including any preferred pronouns, and your involvement in furthering GBS research and disease prevention.

Which of the following would you like to join as? ^*

Researcher (including university students)

Healthcare Professional (including medical students)

Health Advocate (including academics, policymakers, nonprofit representative, doulas, etc.)

Please check all that apply

If you chose Other, please specify your profession(s):

Organization/Affiliation ^*

Organization/Affiliation Email ^*

Please add your organization/affiliation email for verification purposes.

Department

Position ^*

City

Phone

Country ^*

If you chose Other, please specify your interest(s):

If you are applying as a Researcher, please upload a list of your published research or your CV:

School

I would like to be a

Profile Visibility ^*

Facebook

Twitter

Instagram

Website

Address Details ^*

Tell us about your organization: ^*

What is/are your organization’s interest(s) in GBS? ^*

Perinatal Health

Maternal Health

Non-pregnant Adult Health

One Health

Other

Please check all that apply

If you chose Other, please specify your organization's interest(s) in GBS:

Which region(s) does your organization operate in? ^*

Global

North America

South America

Asia

Europe

Oceania

Does your organization offer grants for research?

Yes

Settings

Work Section visibility to Other Members

Settings

Receive Private Messages from Other Members

Settings

Looking For A Job

Settings

Education Section visibility to Other Members

Membership Plan

Membership Plans

I accept terms of use and privacy policy.

Once your application is submitted, you'll be notified within 1-3 business days (less than 12 hours if just prior to our events) regarding approval of your membership. Please check your spam or junk mail folder to make sure you don't miss any of our notifications.

Applying as a sponsor? Once your application has been approved, you'll be able to log in and submit payment via credit card or wire transfer. Please contact us if you need to request an alternate form of payment.

Questions? Please contact us at info@gbs-intl.org