International Society of Radiographers and Radiological Technologists
Application for Associate Membership
Please complete in block letters and return to: ISRRT, 143 Bryn Pinwydden, Cardiff, CF23 7DG, Wales,
United Kingdom
Title (please tick): Mr.
 Mrs.
Ms.
Family Name(s):
Miss.
Dr.
Other
Given Name(s):
Address:
Email address:
I wish to support the work and objectives of the ISRRT and hereby apply for Associate Membership.
Pounds Sterling
1 year £6.00
3 years £16.00
U.S. Dollars
1 year $12.00 US
3 years $30.00 US
I am a member of my National Society which is:
Speciality: (please tick one or more):
Imaging Therapy Nuclear Medicine
Signature:
21433 v.1
Canadian Dollars
1 year $14.00 Cdn
3 years $32.00 Cdn
Education
Date:
Euros
1 year 10 Euros
3 years 28 Euros
Management
Ultrasound