Join APEM > Step 1

To become a member you will need to complete the following:

  • The online form below
  • Download our Direct Debit application form, complete and send to APEM

Once the Direct Debit has been setup we will activate your membership and confirm via email. This will give you access to our Members Area.

Title:
* Firstname:
* Lastname:
* Job Title:
* Unit / Centre / Department:
* Hospital:
Qualifications:
Contact Details
* Address 1:
Address 2:
* Town:
* County:
* Post Code:
* Telephone:
Mobile:
Facsimile:
Misc Details
Notes:
CEM member: Yes No
RCPCH member: Yes No
Gift Aid Certificate: Yes No
Mailing list optout: Yes No
Email Alerts
Important Updates:
Information of Public Importance:
Events:
News:
Training:
Bulletins:
Documents:
Image Gallery:
Meetings:
Research Networks:
Video Gallery:
Member Login Details
* Email:
* Password: (minimum of 8 characters)
Confirm Password: