Online Application

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PLEASE NOTE THE UKISCRS MEMBERSHIP YEAR RUNS FROM JANUARY TO DECEMBER AND IS RENEWABLE AT THE START OF A NEW CALENDER YEAR

Online Membership Application 2015

Please complete all sections. Sections marked with a * are compulsory.

Personal Details
Title *
First Name *
Surname *
Job Title *
Base Hospital *
Address Line 1 *
Address Line 2
Town *
County
Postcode *
Country
Telephone *
Fax
Email *



Registration Fees
Please select the relevant registration fee:
 Consultant £125
 Career Grade £100 (e.g., Staff Grade or Associate Specialist)
 Retired £60

Trainee applicants
Please send proof of training post on Trust letterhead to gillwood@ukiscrs.org.uk


 UKISCRS Industry Support Group

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