Contact Details

Below please complete with the name of the nominee:

Applications can be submitted by completing this online form.

Each nomination must include:

  • A brief summary (maximum 400 words) outlining the nominee’s achievements, impact, and relevance to endometriosis care or awareness.

Please upload documents in formats such as: PDF/WORD ( DOCX ).


By using the next button to register, I agree the use of my personal data for purposes related to the Congress participation, under the GDPR requirements.
- The GDPR stating document can be seen HERE

Data Processing Consent

Data Processing Consent option required

Thank You


We are using a temporary cookie to streamline your experience. No personal data is stored and the cookie is removed once you complete your registration.

Your Browser Settings have Cookies Disabled

This site requires a temporary cookie to streamline your experience. No personal data is stored and the cookie will be removed once you complete your registration. Please enable cookies in your browser and refresh this page.