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Registration for joining NATO HFM-099/RTG-033
For those wishing to join NATO Human Factors and Medicine Panel 099/Research Task Group-033, online registration is preferred to registration by e-mail, fax, or regular mail. Information collected in the registration process will be used to establish a mailing list for announcements about future RTG-033 activities.

  • To join NATO Research Task Group-033 online, fill in the requested information below then click the “Submit Form” button at the bottom of this page.
  • To join offline, print this document (set your browser’s printing preferences/orientation/page
    option to “landscape”), use a pen to fill in the required information, then fax it to 301-295-1863 (Attn: William F. Blakely), or send it via regular mail to:
          William F. Blakely, PhD, RTG-033 Chairman
          AFRRI
          8901 Wisconsin Avenue
          Bethesda, MD 20889-5603 USA
Membership in Research Task Group-033 is open only to those who are eligible by NATO and whose countries have been endorsed by their governments and invited by the RTG-033 chair. To join Research Task Group-033, please provide the following information so that we can notify you about current and future events. Fields marked with an asterisk (*) indicate required information.

Title:
  Examples: Professor, Mr., Miss
*First name:
Middle initial:
*Last name:
Suffix:
  Examples: Jr., III
Professional degree:
  Examples: PhD, MD
Military rank:
(spell out and include 
preferred abbreviations) 
  Examples: Rear Admiral (RADM), Major (Maj.)
Department:
Organization:
*Address line 1:
Address line 2:
Address line 3:
*City:
*State/Province:
Postal/ZIP Code:
*Country:
Phone
  
*Nation code (Use 1 if USA):
*Area/city code:
*Local number:
Work fax
  
*Nation code (Use 1 if USA):
*Area/city code:
*Local number:
*E-mail address:
Job title:
Area of expertise:
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May we add you to our mailing list to receive information about HFM-099/RTG-033 activities?
Yes

May we include your name and institution as an HFM-099/RTG-033 participant in our informational materials?
Yes

Country representing:

Select one of the following:
Official lead representative for above country
Official delegate for above country
Official observer for above country
Other (explain):

The HFM-099/RTG-033 is expected to be organized into four subdisciplines. Select one of the following that represents the registrant's primary contributions:
Radiobiology Mechanisms and Late Effects
Radiation Injury Assessment and Biodosimetry
Prophylaxis and Therapy
Combined Injuries and Treatment
Other (explain):

Select if appropriate:
I am willing to serve as a subgroup chairman for HFM-099/RTG-033.


    

Please address your questions and/or comments to:
Dr. William F. Blakely
AFRRI
8901 Wisconsin Avenue
Bethesda, MD 20889-5603 USA
Voice mail: 301-295-0484
Fax: 301-295-1863
E-mail: rtg-033chairman@afrri.usuhs.mil

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