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RSP Healthcare Consortium

Complete Membership Form to Join Consortium or Agency group
Consortium and Associate members have voting rights allowed by membership type.
 MEMBERSHIP TYPE
Consortium       Agency
 MEMBERSHIP FEE
 Membership Fee: £550
 MEMBERSHIP APPLICATION
* Company:
Date: Calandar
Address:
Town / City :
County:
* Post Code:
Web Site Address:
RSP HC Contact:
   
 KEY DIRECTORS / REPRESENTATIVES / REFEREES / SUPERVISORS
* Name:          
Date of Birth: Calandar  Calandar
Title:          
* Address inc Post Code:          
Phone:          
Fax:          
* E-Mail Address:          
CV:   
 
 MEMBER CLASSIFICATION
Sector Classification Doctor Psychologist General Nurse Specialist Practitioners Midwife Health Visitor Dentist Clinical Cosmetic & Reconstructive Medicine Counsellors Therapist Home Care Medical Escort Allied Healthcare and Nursing Agency Staff Medical Partners Other please specify
Member Dues Category: Please select your dues category
   15,000.00 - 26,500.00 For-profit organisations with annual gross revenues of 25 million or more (Ask for more details).
    10,500.00 For-profit organisations with annual gross revenues of between 11 million and 24 million.
   5,250.00 For-profit organisations with annual gross revenues of between 5 million and 10 million.
   2,650. For-profit organisations with annual gross revenues less than 5 million.
   5,250.00 Non-profit organisations with revenues of 25 million or more.
   2,450. Non-profit organisations with revenues less than 25 million.
   550.00 Individual practitioners.
   
Method of Payment:  Pay via cheque.
   Pay via all major credit card only.
* Upon submitting this form, you are confirming that you understand that you are obligated to pay membership dues within and that all dues are non-refundable.
Description: Declarations of convictions spent and unspent
Enter details below or upload with online form
 
   
Enhanced Disclosure & Barring (D&B) check done in the last six months only is acceptable.  Forward your completed registration form and CV to: careers@rsphealthcare.com  The original copy of your D&B certificate must be made available by post to 'Membership Administrator' at the address later provided.  Complete the online Contact form if you require further registration or membership assistance.
 
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