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Solo Membership

It should only take about 5 minutes to complete your solo membership.
All fields are required.

Gender (Discrete)

This field will be auto populated based on the 'Gender' dropdown selection. It should contain at least 1 number but could contain multiple from a 'Team' subscription where multiple members have been added.

Grade (Discrete)

This field will be auto populated based on the 'Grade' dropdown selection. It should contain at least 1 number but could contain multiple from a 'Team' subscription where multiple members have been added.

Retire (Discrete)

This field will be auto populated based on the 'Retire' dropdown selection. It should contain at least 1 number but could contain multiple from a 'Team' subscription where multiple members have been added.

First Name

Last Name

Gender

The e-mail address that NSNF emails should be sent to

Backup Email Address

We will only use this email address if we lose contact with you via the main email address you provided above.

Personal Phone Number

We will only use this if we lose contact with you via both of your email addresses given above.

Home Address Line 1

Home Address Line 2

Home Town or City

Home Postcode

Please tell us your role

Grade

Do you plan to retire in the next five years?

Work Organisation

Please tell us the name of your Hospital Trust, Service, or Institution.

Work Postcode

Scope of Practice

Please indicate which best describe your role

Hyper Acute

Acute

Intermediate and Continuing Care

Rehabilitation

Community

Primary Care and Prevention

TIA Services

Research

Education

Voluntary Sector

Other

I consent to the above information being entered onto the National Stroke Nursing Forum Database which can be accessed by members of the forum only

I have read and agree with the NSNF membership terms and conditions

Almost done

Click the button below to submit your membership request and arrange payment through our provider, GoCardless.

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