ITS - NI Membership Payment form
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Title
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Prof
Dr
Mr
Ms
Mrs
First Name
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Last Name
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Job Title
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Member of British Thoracic Society?
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Yes
No
BTS Membership Number
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Member of Ulster Thoracic Society?
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Yes
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Type of membership that I am applying for
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Ordinary
Associate
GRHP
Membership Category - Ordinary Type
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Consultant Respiratory Physician
Thoracic Surgeon
Internal Medicine Physician
Consultant Paediatrician
Consultant Radiologist
Consultant Histopathologist
General Practitioner
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Ordinary Type - Other
Ordinary Membership Payment Options
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ITS Ordinary Membership only (€90)
ITS Ordinary Membership to include ERS Dual Membership (€120)
Membership Category - Associate Type
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Specialist Registrar
Trainee Doctors
NCHD
Other
Associate Type - Other
Associate Membership Payment Options
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ITS Associate Membership only (€60)
ITS Associate Membership to include ERS Dual Membership (€90)
Membership Category - GRHP Type
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Nurse
Physiotherapist
Respiratory Physiologist
Scientist
Pharmacist
Nutritionist
Other
GRHP Type - Other
GRHP Membership Payment Options
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ITS GRHP Membership only (€15)
ITS GRHP Membership to include ERS Dual Membership (€45)
Institution
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E-mail
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Phone Number
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-
Country Code (+44)
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Area Code
Phone Number
Special Interests
Asthma
Lung Cancer
ILD
COPD
Bronchiectasis
Pulmonary Fibrosis
Cystic Fibrosis
Pleural Disease
Sleep
Paediatric
Thoracic Surgery
Radiology
Histopathology
Integrated Care
Transplant
Other
Special Interests (Affiliate and GHRP)
Asthma
Lung Cancer
ILD
COPD
Bronchiectasis
Pulmonary Fibrosis
Cystic Fibrosis
Pleural Disease
Sleep
Transplant
Oxygen Clinic
Pulmonary Rehab
Respiratory Physiology
Integrated Care
Other
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