Membership - Pay Later

To join BACME and pay by cheque or bank transfer, please note the information below then complete and submit the form.

If you have any questions about BACME membership, please click here to email the Membership Secretary. For administrative or general inquiries, please contact info@bacme.info

Bank transfer instructions

Please make payment to the following account and reference your name plus MEMB eg, EPresleyMEMB

BACME Treasurer’s account, Lloyds Bank

sort code 30 98 97 account number 53060768

Cheque payment instructions

Please make cheques payable to BACME and post to:

BACME Treasurer Christine Oliver, East Midlands CFS/ME Network Coordinator,

Specialist Rehabilitation, London Road Community Hospital, London Road, Derby DE1 2QY

Please ensure that the name you use for your BACME records is enclosed with your cheque or reference on your bank transfer, if it is different from the name on your bank account.

Membership Fees

Please renew my membership automatically.

Total Amount

Email Address *

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.

Name and Address

First Name *

Last Name *

Street Address *

Street Address 2 *

City *

Postal Code *

County *

Country

Payment Options

[x] I will send payment by cheque / bank transfer

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

County *

Postal Code *

Membership Information

Current Role/Job Title *

If other, please specify

Professional Registration Body

Professional Registration Number

CFS/ME Service *

Type of Service

Service Lead?

Yes No

Any Other Comments

I confirm that I support the BACME Constitution (click here to download PDF.)

In providing the above information, I consent to my name and contact details being kept by BACME and used to contact me with BACME mailings and newsletters, and to remind me of membership expiry. I understand that this information will not be shared without my permission and that I can review or withdraw my data at any time.

(Please tick the box below to confirm.)

Declaration

Confirm