APPLICATION FORM FOR MEMBERSHIP OF WORLD FEDERATION OF ACUPUNCTURE-MOXIBUSTION SOCIETIES
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APPLICATION FORM FOR MEMBERSHIP OF WORLD
FEDERATION OF ACUPUNCTURE-MOXIBUSTION SOCIETIES
Secretariat use only
Reg. No.: Date Received: |
Please complete this form and return it to:
WFAS Secretariat（16 Nanxiaojie, Dongzhimennei, Beijing
100700, China）
Name of applicant
Date of Application
Information of applicant
English Name
Chinese
Name
Country / Region
Date of founding
Authorities of organization registered
with:
Total Number of Members
Number of Doctors of Acupuncture and
TCM
Number of Western Medicine Doctors with Certificate of
Acupuncture
_______________________________________________________
Number of Acupuncturists
Number of Other Researchers or Students related
with Acupuncture
Name of President
Term of post (Year to Year)
Mailing Address
Tel: Fax:
E-mail：
Name of Liaison Person
Mailing Address
Tel: Fax:
E-mail：
Permanent Mailing Address of Organization
Tel: Fax:
E-mail：
Web
Site
Is there any sub-parties of your
society?
Yes □
No□
Name of the sub-parties
Date
Signature
Brief Introduction to the History and
Academic Activities Related to Acupuncture of the Applicant
World Federation of Acupuncture-Moxibustion Societies