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Application Form

Application Form: Membership

If you are pharmacist or holding another university diploma and are working in the pharmaceutical industry in Switzerland you are kindly invited to apply for GSIA/SSPI membership by filling in the form below.

We will contact you as soon as we have received your application details.

Submit us your application details

About you

Title

Last Name

First Name

Private Street

Private ZIP Code

Private City

Private Country

Date of Birth

Nationality

About the company

Company Name (complete)

paying office (e.g. Zentraler Fakturaeingang, Kreditorenbuchhaltung)

Company Building/Office

Company Street

Company Zip Code

Company City

Company Country

Company Phone

Company Fax

Email Address

About the billing

We need some information how we will have to send you the membership fee bills.
Billing company name:

Financial department

Responsible person in the financial deparment

Street

P.O. Box

ZIP code

City

Country

About your education

Education

University

Graduation Year

Working Field

Job

About the membership

Member of pharmaSuisse (former SAV/SSPh):

Yes

Membership Fee paid by Company

Yes

Are you a human being? (yes or no)

Member fee is only 30 CHF per year and will be invoiced after approval of your application.

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