Membership Form

In order to ensure your application can be submitted, please review all required fields and mandatory documents before proceeding

Family Name *

First Name(s) *

E-mail * *E-mail will also be your username for logging in

Confirm E-mail Address *

Gender *

Date of Birth (MM/DD/YYYY) *

Organization *

Address *

City *

State/Province

Country/Region *

Postal code

Work Phone * Numbers only no spaces

Fax Numbers only no spaces

Mobile Numbers only no spaces

Where did you first hear about SIU ? *

Where did you first hear about SIU - Other

Why did you decide to join the SIU ? *

Why did you decide to join the SIU - Other

The SIU will use the information you provide on this form to send you updates and information. Please let us know which of our many features are of interest to you.

I would like to receive SIU emails regarding news and updates on SIU activities, including eLearning, research, philanthropy, and events.

Please note that all SIU members will automatically receive communications relevant to the functioning of the Society, such as dues reminders, call for nominations and bylaw updates. These communications will cease once the member has resigned.

For more on our privacy practices please go to https://www.siu-urology.org/society/privacy-policy. By selecting the options above, you agree to our processing your information in accordance with these terms.

Membership Type Requested

Username

Create your password * At least 6 characters

As a Urologist, a copy of proof of Board Certification must accompany your application (PDF, DOC, DOCX, JPG, JPEG)

Certification

Certification Country/Region *

Certification Authority *

Certification Date (YYYY) *

Authorization

As a Resident, a certified letter by the head of the training unit must accompany your application (PDF, DOC, DOCX, JPG, JPEG)

Training Unit Head *

Training Institution *

Expected Date of Training Completion *

SIU Academy

Area of Specialty/Interest *

Are you a resident/trainee? *

Area of Specialty/Interest - Other

* I hereby certify that the information entered above are true and correct to the best of my knowledge.

* I certify that I am a healthcare provider and/or a healthcare industry professional.

Trainee and Senior Members who wish to receive an online subscription to the World Journal of Urology are required to pay an annual fee of US $25

Do you wish to receive the Journal? *

Referral

Are you referred by a member of the Société Internationale d'Urologie to join? * *Please note that the referring member must be an active member of the SIU.
*Application for Active membership requires sponsorship by 1 Active Member of the Society in good standing.

Member Family Name *

Member First Name(s) *

Member Country/Region *

Member E-mail *

Specialties

Oncology

Adrenal cancer
Bladder cancer
Kidney cancer
Pediatric genitourinary malignancies
Penile cancer
Prostate cancer
Testis cancer
Urothelial tumours of the upper urinary tract and ureter

Non-oncology

Adrenal benign conditions
Diagnostic urology
Infections and inflammation
Kidney: benign conditions and kidney failure
Lower urinary tract dysfunction
Pediatric urology
Reproductive and sexual health
Robotics and minimally invasive surgery
Stone disease and endourology
Transitional urology
Trauma and reconstructive urology

Other Specialty Text

Country

Dues categories *

Payment of annual dues entitles the member to unlimited access to the SIU Academy, and reduced Congress registration fees.

Membership dues are currently - per year. Members from developing countries receive a discount on annual dues based on World Bank GDP classifications. Dues categories (A, B or C) for all countries are available on the SIU website www.siu-urology.org

* United States Only: A surcharge of US $30 will be added

Amount : $0

Payment method

Cardholder's name *

Credit card number *

CVD ? *

Exp. Month *

Exp. Year *

By Bank Transfer* in US Dollars
SIU Bank Account # 00001-4030326 (USD)
RBC Royal Bank of Canada,
1 Place Ville Marie
Montreal, QC, Canada, H3C 3B5
SWIFT CODE: ROYCCAT2
Beneficiary Name: Société Internationale d'Urologie
*Please ensure your name and membership number are clearly identified as the ordering customer on the bank transfer request.

Please note that your membership will only be finalized once we have received the payment if you choose to pay by bank transfer. You can send us your bank transfer confirmation at [email protected] if you wish to accelerate the process.

No payment required

Payment instructions will be provided after form submission.

SIU Privacy Policy
By clicking on the Submit button, you agree to the terms of the SIU Internet Privacy policy.

Membership Types

Active Members

Active members must be qualified urologists. The status of qualified urologist requires that the Urologist be certified: by a foreign or international accrediting body recognized by the Board of Directors; or by a national accrediting body in the country of the candidate; or by the recognized national urological society in the country of the candidate; or in special circumstances by the Board of Directors itself.

Application for membership requires sponsorship by one (1) Active or Senior Member of the Society in good standing. The applicant will be considered an Active Member immediately if the requisites of the application are fulfilled, the dues are paid and the General Secretary has reviewed and approved the application.

Read full bylaws by clicking here

Associate Members

Urologists or surgeons practicing urology but not considered qualified as per the above definition may become Associate Members. The applicant will be considered an Associate Member immediately if the requisites of the application are fulfilled, the dues are paid and the General Secretary has reviewed and approved the application.

Associate Members are non‐voting members of the Society.

Read full bylaws by clicking here

Affiliated Members

Physicians or health professionals engaged in affiliated branches of medicine may also become Affiliated Members.

The applicant will be considered an Affiliated Member immediately if the requisites of the application are fulfilled, the dues are paid and the General Secretary has reviewed and approved the application.

Affiliated Members are non‐voting members of the Society.

Read full bylaws by clicking here

Trainee Members

Physicians who are engaged in full‐time training in Urology may apply for Trainee Membership. The status of trainee in Urology (i.e. resident, registrar, fellow or other training post in Urology) must be certified by the head of the training unit.

The applicant will be considered a Trainee Member immediately if the requisites of the application are fulfilled and the General Secretary has reviewed and approved the application. At completion of the Urology training or after a maximum of five (5) years as Trainee Member, and upon certification of qualification as described in Article 1 above, the Trainee Member will become an Active, Associate or Affiliated Member.

Trainee Members are non‐voting members of the Society.

Read full bylaws by clicking here

What is a CVD (CVV2/CVC2)?

The CVD code (or CVV2/CVC2) is a special 3-4 digit code used as an additional security measure for online transactions.

On most cards, this number is a 3-digit code on the back of your card, near the signature strip. On American Express cards, the 4-digit code is above and to the right of your card number on the front of the card.

Certification

Authorization

SIU Academy

Referral

Specialties

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