Fellowship of AOA - AOA | Australian Orthopaedic Association

1About you
2Contact & addresses
3Credentials
4Review & pay

Personal details

* Title

* First name
(Please use full given name)

Other name(s)

* Last name

Preferred name
(Leave blank if the same as First Name)

* Date of birth

Spouse's name

Passport photo

* Passport photo

Allowed: PDF, JPG, PNG. Max size: 10MB.

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Contact details

* Email

Home phone

Work phone

* Mobile phone

Fax

Home address

Preferred address

* Address 1

Address 2

* Suburb

* State

* Postcode

* Country

Practice address

Preferred address

* Address 1

Address 2

* Suburb

* State

* Postcode

* Country

Professional qualifications

* Degrees and diplomas (with awarding institutions and names)

Curriculum vitae

Attach curriculum vitae, which must include:

All appointments since graduation with dates, period, nature of duties and names of surgeons concerned
Nature of present professional practice
Titles and references of publications in orthopaedic surgery

* Upload file

Allowed: PDF, DOC, DOCX. Max size: 10MB.

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CPD compliance

Are you CPD compliant?

Upload your CPD certificate

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Proposers

* Proposer's name

* Seconder's name

Review your application

About you

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Contact & addresses

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Credentials

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I agree with AOA membership application terms and conditions.

Payment details

Application fees $210.00

* Credit card type

* Name on credit card

* Credit card number

* Credit card expiry

* CCV