FEND Membership Application

Membership form

Fill in this form to join FEND

Membership *

Full Member - £ 50.00

Total Amount

Account

Please enter a Username to create an account. If you already have an account please login before completing this form.

Username *

Check Availability
Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores.

Your Details

Email *

First Name *

Last Name *

Address Line 1 *

Address Line 2

Address Line 3

City *

Post Code *

Country (Primary) *

Phone (pref mob) *

Job Title *

Qualifications

RN

MSc

PhD

When did you start? (year)

Special interests

Membership Requirements

Please tick boxes to confirm that:

1 *

I am a registered or licensed nurse

2 *

I am not employed by a pharmaceutical company

3 *

I work in the speciality of diabetes

To be a member of FEND all three condition must be true.

We accept the following cards for payment - VISA, Mastercard

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