Membership Application

Thank you for your interest in GLODERM Membership.

Your participation as a GLODERM Member will help achieve our mission of Skin Health for Everyone, Everywhere. All membership donations will go directly toward enabling our initiatives to invest in dermatology change-makers in medically underserved areas. With your contribution, we can continue to expand our mentorship and leadership opportunities to a growing community of changemakers, who will go on to create a lasting public health impact in their community.

Membership is open to any dermatologist, dermatology trainee, or primary care provider/qualified health worker with a special focus on dermatology.

Further information can be found on the GLODERM website.

Alternatively, if you have any questions, please contact us: info@gloderm.org

Membership categories

Voting Member
A dermatologist, or primary care provider/qualified healthcare worker with a special focus in dermatology, licensed to practise medicine in their home country.

Active Member
A researcher, member of a sponsoring organisation, and member of a community organisation with a focus on skin health. Dermatologists who wish to support the mission of GLODERM, but do not wish to obtain voting membership, can join as active members.

Trainee Member
A dermatology resident, primary care resident, or student with a special interest in dermatology.

Dues and benefits

Your details

Salutation

First Name

Last Name

Email Address

Profession

Please confirm your place of work (or university if trainee)

Country of residence

What are your main areas of interest in global health dermatology?

If you would like to select more than one interest, please do so by holding down the Ctrl button and selecting the options you like

Please specify

Type of membership

What category of membership do you wish to apply for?

If you would like to apply as a Voting Member but are not able to pay the fee, we would be happy to discuss this with you. Please contact info@gloderm.org.

Payment of dues

Amount due

$

Credit Card Information

Name on Card

Card Number

MM

YY

CVV Code

Billing Email

Billing Address

City

Country

State

Province

Zip Code

GLODERM Community Directory

The GLODERM Community Directory is an online directory to connect like-minded GLODERM Members.

The GLODERM Community Directory allows you to filter members by country, region, or area of global health dermatology interest. Your email address will not be displayed.

If Members are interested in connecting with a specific individual, they will need to contact GLODERM with their request. We will always ask for consent before sharing your email address.

Are you happy to be included in the GLODERM Community Directory

Confirmation

Eligibility
By submitting your application for membership, you confirm that you meet the eligibility criteria for the type of membership you are applying for. However, please be aware that if the GLODERM Steering Committee reviews your application and determines that you are not eligible, your membership may be revoked.

I confirm that I am eligible for the category applied for.

Please click below to submit your application.