Hong Kong Association of Rehabilitation Medicine (Hong Kong, China)
香港康 復醫學學會
Membership Application / Renewal Form Name:
__________________(中文)
Sex:
M/F
Please “” as appropriate: New Membership Application Membership Renewal (Only need to fill in the following if there is change in information) Organization: _______________________________
Type of membership applying or to be renewed: Full member (HK$400 per year for combined HKARM / ISPRM annual subscription) - Medical practitioners registrable and practising in clinical rehabilitation services in HK. Associate member (HK$200 per year) - Medical practitioners registrable in HK & practising in other fields or allied disciplines or nurses registrable in HK, who show an active interest in rehabilitation medicine. Life member (HK$2,000) - Elected from full members who have paid the life membership subscription. (N.B. Annual membership subscription expires at 31 Dec of each year.) Applicant’s Signature: ______________
Date: ______________ Cheque No.: _____________
For new applicant, nominated by (current Full Member): __________________________________ Please enclose the crossed cheque payable to “Hong Kong Association of Rehabilitation Medicine” and send to the following address. ----------------------------------------------------------------------------------------------------------------------------Attn.: Dr. Eric Yeung (Honorary Treasurer, Hong Kong Association of Rehabilitation Medicine) Department of Rehabilitation M/F, Kowloon Hospital Rehabilitation Building, 147A Argyle Street, Kowloon.
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opportunities overseas or, where required, to enable the IET to meet any legal or other legitimate obligations in that country. IET products and services are ...
Home Country/State: Undergrad ... Musical Director and the committee, and that failure to pass an audition will result in the termination of membership. Should.
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Membership Application 2016-2017. Return this form to any Executive Board Member It's never too late to join! Membership Fee- $26. PLEASE PRINT CLEARLY. NAME: ...
Membership of âDwarka Forumâ. I/We hereby confirm that I/We am/are the bona-fide Resident / Regd. Body of Dwarka Sub-city, New Delhi and also I/We am/are regularly residing in the above mentioned address with my family members. Contact Details: P
MEMBERSHIP APPLICATION. PERSONAL INFORMATION. Name: Institutional affiliation and position (if any):. Address: Eâmail address: We will never pass personal information (incl. contact details) on to third parties. MEMBERSHIP PACKAGE. Please tick appr
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These forms can also be delivered to the OBSID office in 21 Lower Main Road or to the Library in Station Road. You can also scan the completed form and email ...
A service charge of. $15.00 will be assessed for all returned checks. Comments to Staff: Yes! I want TLCA to automatically renew my membership every year.
By signing this application, I authorize the Association, (including local, state and national) or their subsidiaries or representatives to fax, e-mail, telephone or ...
original application to the International Executive Office of the Fraternity within ten days of the initiation ... Permanent Phone Number ... Executive Office Use Only.
Date received. Payment received. Accepted/Declined. Election date. Page 2 of 2. Junior Membership Form 2017.pdf. Junior Membership Form 2017.pdf. Open.
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