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STEP 2: Profile Setting
*
:required fields

First name * Last name *
Title  
Password * Retype password *

 
Your official address (to be posted on the PRINTO website)
Hospital *
Department *
Street *
Postal code * City *
Country * Mobile
Phone 1 *
Phone 2
Fax 1 *
Fax 2
Email1 /User ID *
Email 2
website
 

 
Your mailing address
(where PRINTO has to send all the documents, change the value if different)

*:required fields
Hospital *
Department *
Street *
Postal code * City *
Country * Mobile
Phone 1 *
Phone 2
Fax 1 *
Fax 2
Email1 *
Email 2
 

Curriculum Vitae *:required fields
 
1 Date of birth (dd/mm/yy) *      
2 Sex *

   
3 English Knowledge *

basic good fluent
4 Year of graduation from medicine/medical school *
5 Number of Specialty(ies) completed* (number)
Year completed (yyyy)
  Specialty (tick all that apply)
  (1) General paediatrics
  (2) Paediatric Rheumatology
  (3) Adult Rheumatology
  (4) Physical medicine & rehabilitation
    Other (specify)
  (5)
  (6)
  (7)
6 Main field of study/research (no more than 2 line) *
 
7 Years of experience in paediatric rheumatology (number) *
8 Professional experience (example: senior doctor or consultant from to, etc) *
 
9 Honours and awards
 
. Please list your top 5 pubblication
  a)
  b)
  c)
  d)
  e)

Copyright IRCCS Istituto G. Gaslini, Universita' di Genova
Pediatria II, Reumatologia, EULAR Centre of Excellence in Rheumatology 2008-2013
Largo Gaslini, 5 16147 Genova, Italy