Membership Form

Please complete the following details for your registration:

Personal Details

Title

First Name:

Surname:

Gender:

Age:

Address 1:

Address 2:

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Telephone:

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Login Details

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Create Password:

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Membership Type:

Full Member ( £90 ) Trainee/Radiographer ( £45 )

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Payment Method: Online / Paypal / Credit Card BACS (UK only) or IBAN (all non-UK payments) Go Cardless

Please tick this box if you wish to be contacted by e-mail with other ICIS information and services We can only notify you of upcoming ICIS courses and online content if you opt in. If you do not opt in we will not be sending you any information.

Please tick this box if you wish to be contacted with information from other organisations related to cancer imaging

Trainee Membership
Please send or scan a letter of authorisation with the finish date of your course/training through to either:
Address:

International Cancer Imaging Society (ICIS) 41 Waddington Way, London, SE19 3UB

E-mail: [email protected]
OR
upload your scan directly to us below.

Upload your letter of authorisation with the finish date of your course/training here (if required):

To pay by debit or credit card with Paypal view the screenshot below.