APPDE

Membership Form (Jan 2011 - Dec 2011)

To join the APPDE, fill in the your details on the online form below OR you can download the application form and email or post your completed form to the membership secretary.


Your membership will be confirmed on receipt of your payment by bank transfer or cheque (see payment details below).


* Required Information

Contact details for correspondence

Title

 
First Name

 
Last name

 
 

 

 
Telephone

 
Fax

 
Email Address

 *

If you are a qualified physiotherapist, please give your national registration details

If you are a student physiotherapist, please provide the name of the institution in which you are studying

If you are not a physiotherapist, please state profession or interest in PD

Place of work (if applicable)

Membership category *

Please select one

 

ANNUAL FEE

 

25€ (£21)

4 members

Each additional member

Number of members

75€ (£62)

25€ (£21)

 

10€ (£8)

 

75€ (£62)

 

15€ (£12)


Payment details

Payment may be made in Euros or Pounds Sterling

By Bank transfer (please ensure that you use the correct bank information)

Bank Address Lloyds TSB, Morpeth Business Centre, PO Box 816, Newcastle, NE99 1WS, United Kingdom
   
  Payments in EUROS, € Payments in POUNDS STERLING, £GBP
Account name APPDE APPDE
Sort code 30-95-76 30-95-76
Account number 86273614 1693498
IBAN number GB65 LOYD 3095 7686 2736 14 GB54 LOYD 3095 7601 6934 98
SWIFT code (BIC) LOYDGB21342 LOYDGB21342
Reference Please quote 'EMemb.' followed by you name Please quote 'UMemb.' followed by your name

ALTERNATIVELY, YOU CAN PAY BY A £ STERLING CHEQUE (NO EURO CHEQUES PLEASE *): -

Please send a cheque made payable to APPDE and include it with your completed membership form.

* This is due to excessive UK bank charges to pay a cheque into our Euro account!


Please send your payment if appropriate to: -

MS BHANU RAMASWAMY, Membership Secretary, APPDE, 31 Burcot Road, Sheffield, S8 9FD, United Kingdom


Method of Payment  *