UKSMO Membership Registration Page

Contact Details

Title

First Name

Last Name

Present post / Job title

Organisation Area

Organisation - NHS England

Organisation - NHS Northern Ireland

Organisation - NHS Scotland

Organisation - NHS Wales

Please type your organisation here:

Address Line 1

Address Line 2

Address Line 3

City

County/State

Postcode

Country

To ensure UKSMO emails are not blocked by your nhs.net address, please provide a non-NHS email.

Non-NHS email

Verify Email

Additional Email

Telephone

Consultant

AMOUNT

100.00

TOTAL

Medical Oncology Specialist Trainee

AMOUNT

50.00

TOTAL

Non-Career Grade Doctor

AMOUNT

50.00

TOTAL

Retired

AMOUNT

0.00

TOTAL

Billing Address

The Contact Address is the same as the Billing Address

The Billing Address is different to the Contact Address

First Name

Last Name

Organisation

Address Line 1

Address Line 2

Address Line 3

City

County/State

Postcode

Country

Email Address

Summary

Privacy Policy

If you would like to view the ACP privacy notice please click here.

Terms and Conditions

By completing this online form I agree to become a member of the ACP and I am happy to receive communications from ACP regarding my membership, relevant events, activities and general medical oncology news and information. I understand my data will not be shared with third parties.

Agree

Payment Details

Direct Debit

Setting up a Direct Debit means your membership will automatically renew each year, so you won’t need to manually renew your subscription in future.

Simply, complete the Direct Debit Form

Once you have submitted the form, you will receive a confirmation email within a few days.
This email will outline when your Direct Debit has been set up and the dates your payments will be taken.
An initial payment will be collected for this year’s subscription, followed by annual payments thereafter.
You can cancel your Direct Debit at anytime

Please note that the form is provided by SAS Event & Association Management, who manage ACP memberships and collect subscription fees on behalf of the ACP.

UKSMO Membership Form

Contact Details

Billing Address

Further Information

Registered Specialities (CCT)

CCT Date

Date appointed to first consultant post

Date appointed to current consultant post

Sub-Specialisation

Training Region

Please state your Training Region below:

Commenced Medical Oncology Training (month and year)

Are you an academic clinical trainee?

Expected date of CCT (If not known please include current approximation)

Have you completed or do you intend to complete a higher degree?

Do you have a clear sub-speciality (cancer site) interest(s)

PhD

MD

MSc

Current Grade (Non Career Grade Doctor)

Other (Please specify)

Do you intend to complete training in medical oncology and obtain a CCT to CESR (or portfolio pathway)?

Retirement Date

Last post before retirement

Are you still active in any of the following areas?

Support for ACP Application

Participation in Surveys

Membership Directory

Summary

Privacy Policy

Terms and Conditions

Payment Details

Thank you