Membership details Providing your professional details helps us assess your application. Selecting an incorrect membership category will delay your application. Membership category Junior Member - £20.00 Junior Member - £20.00 - 1 Year Trainee Membership, Allied Health Professional Membership, Retiree Membership. Consultant Member - £50.00 Consultant Member - £50.00 - 1 Year Create an account Your username This username will be used to log into your account Your chosen password For information on how to create a secure password click here. Confirm your password Personal details Name Title Dr Prof Assoc. Prof Mr Mrs Ms Miss Surname Given name Date of birth Please enter using dd/mm/yyyy format (e.g. 12/05/1981) Ethnicity and diversity English, Welsh, Scottish, Northern Irish or British Irish Gypsy or Irish Traveller Roma Any other White background Indian Pakistani Bangladeshi Chinese Any other Asian background Caribbean African Any other Black, Black British, or Caribbean background White and Black Caribbean White and Black African White and Asian Any other Mixed or multiple ethnic background Arab Any other ethnic group Contact details All mailed correspondence from the British Society of Paediatric Radiology will be sent to the address specified below. Your email address This email address will be used as a method for the British Society of Paediatric Radiology to contact you. It will not appear on either your public-facing or members-only profile. First line of address Second line of address (optional) City / Town County (optional) Postcode Country United Kingdom Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Reof the Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Reof Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Reof Korea, Reof Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav ReOf Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Reof Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Reof Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Contact number This telephone number will be used as a method for the British Society of Paediatric Radiology to contact you. It will not appear on either your public-facing or members-only profile. Professional details Institution/Hospital/Training scheme Grade/Job Consultant Fellow Trainee Retired Allied Health Professional Professional registration number Proposed CCT date for trainees Please enter using dd/mm/yyyy format (e.g. 12/05/1981) Subspeciality interests Contact preferences Select one (do not complete without selecting) Select this option if you would like to receive information and newsletters from the BSPR via email. I would like to receive information and newsletters from the BSPR via email Select this option if you would not like to receive information and newsletters from the BSPR via email I would prefer not to receive information and newsletters from the BSPR via email By completing your application, you will automatically opt-in to receive appropriate communications from us based on the preferences you have set above. Directory preferences The British Society of Paediatric Radiology website has a members-only directory of its members. You can choose whether to opt-in / opt-out of either directory at any time. Your details are also included in the private members-only directory, un-check this option if you would like to hide your details from the members directory. I am happy for my details to be published in the members directory (only BSPR members have access) Members-only profile The contact details you submit here will appear on your members-only profile, and will not be accessible by all or indexed by search engines (e.g. Google) Contact name Telephone number Email address Common details The details you submit here will be shared on the directories you have chosen to opt-in to above. Profile image Providing a photo helps others identify you around the site. Recommended image size: 500 x 500 (pixels) Upload a photo Biography Your biography will be used on the site to help others know more about you. Don't miss opportunities to stay connected. LinkedIn (optional) Please enter your full LinkedIn profile URL Twitter (optional) Please enter your Twitter account handle Data protection No personal details will be divulged for commercial purposes. Occasionally BSPR may wish to use your name and contact details for a variety of purposes. Please tick the boxes at the end of each paragraph as appropriate to say if you agree to these uses. Internal Research and Audit Purposes - If a request is received from a member for access to the mailing list to perform a study, the protocol for which it has been requested will be submitted for review by the audit/research representative and ratified by the committee. I agree that my information may be used for internal research and audit purposes Agree I disagree that my information may be used for internal research and audit purposes Disagree Enquiries for Personal Expertise - If a request is received for the names and contact details of individuals with specific expertise in a given area from a professional colleague or health care related organisation, which has been approved by a quorum of the committee. I agree that my information may be used for enquiries for personal expertise Agree I disagree that my information may be used for enquiries for personal expertise Disagree External Research and Audit Purposes - if a request is received from an individual or a professional body for access to the mailing list to perform a study, the protocol for which it has been has been requested will be submitted to the audit/research representative and approved by the committee. I agree that my information may be used for external research and audit purposes Agree I disagree that my information may be used for external research and audit purposes Disagree Payment details I agree to the terms and conditions I have read and agree to the membership terms and conditions I agree to the privacy policy I have read and agree to privacy policy