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Joining VASGBI

Membership is currently £25 per annum, payable on 1st September by standing order.

In order to join the society, you need to:

1) Complete the details below and click the Submit button (this is a secure connection, making your details virtually impossible to intercept over the internet)
2) Print out the standing order form, sign and post to Jane Heppenstall (details will be given after submitting your details)

Title:
First name:
Last name:
Primary email address:
Alternative email address:
 
Address for correspondence:
address line 1:
address line 2:
city:
county:
country:
post code:
   
Hospital:
position/post:
 
contact phone number:
work phone number (optional):
 
Choose login details for access to members area of website:
username:
password:
retype password:
 
Bank details for standing order:
If left blank you can enter the details by hand on the standing order form
Name of bank:
Bank address:
Bank post code:
Sort code (just numbers, eg 404777):
account number:
Account name:
 

Your details will be used for the purposes of maintaining the society membership database. Your details will NOT be passed on to any third party.

We would, from time to time, like to email you with information about the Vascular Anaesthesia Society (VASGBI). For example, information about forthcoming VASGBI meetings, or events on the VASGBI website. Also, we occasionally run VASGBI-approved surveys relating to vascular anaesthesia, and we would like to contact you by email or post to take part. Please indicate here if you would like to be contacted by the VASGBI:

--> I am happy to be contacted by the VASGBI: Yes | No

 
Please copy the characters into the box provided: (why?)
If the words are too difficult to read, click here