Membership Form

"*" indicates required fields

Main Contact

Name*

Prefix First Last

Organisation*

Position*

Band*

Address*

Street Address Address Line 2 City County Postcode

Address (for invoices if different)

Street Address Address Line 2 City County Postcode

Phone*

Email*

Branch*

Finance

Corporate Fees - NHS Organisations - access to core events programme and regional events

Please note additional local academy fees may be payable. If applicable, the HPMA admin team will get in touch. Branch Fees: Yorkshire members are charged £505 on top of the corporate fee (if joining the North Academy this fee does not apply). Wales members are charged £682 on top of the corporate fee. Northern Ireland members are charged £355, £1755 or £3005 depending on the size of the people function. These fees have been agreed by the individual branch committees

London Academy – access to core events programme and 150+ Academy events

If applying for London Academy membership, please ensure you have also selected the appropriate corporate fee above.

North Academy – access to core and regional events programme plus north academy events

If applying for North Academy membership, please ensure you have also selected the appropriate corporate fee above.

Total

Payment Options*

All bank transfers to be sent to: Account : 03380534 Sort Code : 30-96-00

BACS or Credit Transfer

Invoice

Consent*

I wish to join the HPMA for one year as a corporate member and agree to be invoiced every year until I instruct the administration office to cancel my membership.

I agree

Membership Form

Main Contact

Finance

Interested in becoming a member of HPMA?