Home Membership Application Form
Protection Code:
Please enter the text shown in the image into the field below.
Membership Categories and Annual Membership Fees (please select one)
Position:
Organization:
Email:
Phone No. 2:
Phone No. 1:
Highest Qualification:
Date of Birth:
Country:
Postal Code:
Address:
NRIC / FIN / Passport No.:
Name:
Membership Application Form
Title:
Institutional Membership (Department) S$500
Associate Member (Students) S$20
Full Member (Clinician/non-Clinician) S$100
Click on the button below to complete registration and proceed to payment. Payment can be made via PayPal, credit cards or by cheque.
(DD/MM/YYYY)