NAPICU Personal Membership 2025

PERSonal Membership Application

To apply for membership please complete all questions.
PERSONAL INFORMATION

Important Notice for Membership Application

It is the responsibility of the applying member to ensure that the membership is paid in full. If your company/trust is paying this on your behalf it is the members responsibility to ensure they have the necessary budget and approval to pay the full amount for the selected membership within the specified timeframe.

Thank you for your cooperation.
Prefix*
Mr/Miss/Ms/Mr/Dr/Prof.
First Name*
Surname*
Contact Email*
example@example.com
Contact Number*
Mobile or Landline
Job Title*
Shipping Address for Journals*

Street Address

Street Address Line 2

CityCounty

Post CodeCountry
Are you currently working on a ward or PICU within a Trust or private healthcare company?*

Yes I work on a ward/PICUNo I do not
If you answered "No" to the above question please best describe your workplace:
If you answered "Yes" to the above question, would you be happy to share some information about your workplace with NAPICU? (Please read below for more info.)

Yes I am happy to share some informationNo I would not like to share any information
To help NAPICU maintain accurate and up-to-date records of PICUs and wards across the UK, we invite you to share some basic information about your workplace. This will assist us in future research projects and enable us to better understand the distribution and characteristics of wards, including bed capacities, patient demographics (e.g., mixed, female, male, CAMHS), and other key details.We emphasize that this information is collected for research and data-gathering purposes only, and we will not contact your ward or trust directly based on this information.

Ward/PICU Information (Optional)

To help NAPICU maintain accurate and up-to-date records of PICUs and wards across the UK, we invite you to share some basic information about your workplace. This will assist us in future research projects and enable us to better understand the distribution and characteristics of wards, including bed capacities, patient demographics (e.g., mixed, female, male, CAMHS), and other key details.We emphasize that this information is collected for research and data-gathering purposes only, and we will not contact your ward or trust directly based on this information.
Trust/Private Healthcare Name*
Ward Name*
How many staff are on your ward?*
How many beds are on your ward?*
Please select which most relates to your ward:*
If your ward is not a PICU, please best describe your ward/unit?
Does your ward have a Occupational Therapist?*

YesNoNot currently but we are hiring
Does your ward have a Psychologist?*

YesNoNot currently but we are hiring
Any Additional information:

Membership Type
Membership Period
Memberships run annually from 1st April to 31st March, regardless of the date the membership is submitted.
Membership Type*
prevnext( X )
1 Year Membership
£60.00

Total

£0.00

Billing Address Information
Purchase Order Number
Trust/Organisation Name*
Billing Address*

Street Address

Street Address Line 2

CityCounty

Post Code
Billing Contact Email*
example@example.com

Signature*

Clear
Print Name*
Once completed please return to the administration office – info@napicu.org.uk

NAPICU Administration Office
238 Main Street, Rutherglen, Glasgow, G73 2HP
T: 01355 244 585 E: info@napicu.org.uk
Should be Empty:

PERSonal Membership Application

PERSONAL INFORMATION

Ward/PICU Information (Optional)

Membership Type

Billing Address Information