Canadian Fertility & Andrology Society
By creating a Guest Account, you will be able to login to view all your event/course registrations and certificates of attendance.
Honorific== select == Mr. Ms. Mx. Miss Mrs. M. Mme. Dr. Hon.
First Name
Last Name
Title/Position
Organization
Address
City
Prov/State== select == ==Canada== AB BC MB NB NL NS NT NU ON PE QC SK YT ==USA== AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MR MS MT NC ND NE NH NJ NM NN NV NY OH OK OR PA PL PO PR RI SC SD TN TT TX UT VA VI VT WA WI WV WY ==International== Other
Country== select == Canada United States --- Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Cote d'Ivoire Croatia (Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and Mc Donald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe
Postal/Zip Code
Phone
Preferred Email (this will be used for communications)
Alternate Email
Website (Please insert URL)
Birth Date(month) Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec ,
Professional Credentials (choose all that apply) BA BHSc(N) BN BSW BSc BScN DVM LLB LPN MA MBA MBBS MBChB M.Mgt MD MEd MHSc MLT MN MSW MSc ND PhD RD RN RNC RPN RSW RT Student Other
Other Credentials
Primary Work Activity== select == Administrator Andrologist Counsellor Embryologist Ethicist Geneticist Graduate Student IVF Medical Director REI Physician Lab Director Lawyer Nurse Scientist - Researcher Urologist Other
Other Work Activities
If you wish to join a Special Interest Group (SIG) identify your SIG(s) Leadership and Management Andrology ART Lab Counsellors Ethics and Law Fertility Preservation Genetics Imaging Nurses Research in Reproductive Science 2SLGBTQ+
Bio Profile
Facebook (Please insert URL)
Twitter (Please insert URL)
LinkedIn (Please insert URL)
Google (Please insert URL)
Note: This information is confidential and will not be visible on your member profile. Only you will be able to see this information.
Current Position
Current Employer
Number of years in current position
Are you currently being charged with a criminal offence? Y N
Have you been a Director or an Executive of an organization that has been criminally charged? Y N
Are you governed by a College or other regulating body? Y N
If so, have you ever been the subject of a disciplinary investigation by such body? Y N
Have you ever had a certification of qualification or license to perform your professional activities in any province, or country suspended, revoked, restricted, curtailed or voluntarily surrendered under threat of suspension or revocation? Y N
Have you ever had professional privileges at any health care facility revoked, suspended, curtailed, limited or restricted, or voluntarily surrendered under threat of suspension or revocation? Y N
Have you ever been denied a certificate of qualification or license to practice your profession in any province or has your application for a certificate of qualification or license ever been withdrawn under threat of denial? Y N
Who can view your profile? members only administrators only
Do you want to display your email on your profile? Y N
Do you consent to receive email communications from us? Y N
