Affiliate Membership

Contact Information

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Title *

First Name *

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Professional information

Please only provide academic information if you are CURRENTLY studying. If you have already graduated you should provide your current EMPLOYMENT information.

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Including Department (if applicable)

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Phone Number *

We need at least one phone number for you (mobile, home or work) as we might have to contact you about your application.

Membership Eligibility

Eligibility for Affiliate Membership *

Please indicate which best describes you. I am:

Interests

Academic

Diagnostic Radiology

Industry

Informatics and Computing

Magnetic Resonance

Biomedical Engineering

Nuclear Medicine

Physiological Measurement

Radiation Protection

Radiotherapy

Rehabilitation and Biomechanics

Ultrasound and Non-Ionising Radiation

Paying your membership fee

If you choose to pay for your IPEM Membership by Direct Debit (Annually or Monthly), you need to complete the Direct Debit Mandate below.

Details on ways to pay for your membership can be found on the IPEM website here.

IOP Registration Number (if applicable)

If you are also a member of the Institute of Physics (IOP) you are entitled to 25% discount on your membership fee. Please state your IOP membership category:

Invoice or Direct Debit? Direct Debits payments must be from a UK bank account *

Instruction to your bank or building society

Please pay the Institute of Physics and Engineering in Medicine Direct Debits from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with the Institute of Physics and Engineering in Medicine and, if so, details will be passed electronically to my bank/building society.

Service user number 830217

Institute of Physics and Engineering in Medicine
Fairmount House
230 Tadcaster Road
York YO231PB

Contact: 01904 610821

The Direct Debit Guarantee

This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits
If there are any changes to the amount, date or frequency of your Direct Debit the Institute of Physics and Engineering in Medicine will notify you 7 working days in advance of your account being debited or as otherwise agreed. If you request the Institute of Physics and Engineering in Medicine to collect a payment, confirmation of the amount and date will be given to you at the time of the request.
If an error is made in the payment of your Direct Debit, by the Institute of Physics and Engineering in Medicine or your bank or building society you are entitled to a full and immediate refund of the amount paid from your bank or building society
If you receive a refund you are not entitled to, you must pay it back when the Institute of Physics and Engineering in Medicine asks you to.
You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.

Names(s) of Account Holder(s)

Name of Bank or building society

Account Number

Sort Code

I would like to pay the following by Direct Debit (please tick all that apply)

IPEM membership fee ANNUAL

IPEM membership fee MONTHLY

RCT membership fee ANNUAL

RCT membership fee MONTHLY

Science Council renewal fee ANNUAL

Engineering Council renewal fee MONTHLY

Journal Subscriptions (PMB, PM, MEP) ANNUAL

Please note all fees to the Science & Engineering Council and for Journal Subscriptions must be paid annually

Terms and conditions of payment of annual fees by monthly Direct Debit
1. Monthly Direct Debit installments will be the annual fee divided by 12 and rounded down to the nearest penny.
2. IPEM will collect the monthly Direct Debit instalments on the dates shown on the Direct Debit advance notification, from the IPEM member/RCT registrant’s bank account. For annual renewals these are normally on the 8th of each month. For other payments these are normally on the 8th or the 22nd of the month.
3. If IPEM is unable to collect any Direct Debit instalment from any IPEM member/RCT registrant’s bank account (Bounced DD collection) when it is due, then IPEM will re-present the Direct Debit Instalment collection on the next collection and inform the IPEM member/RCT registrant of this. IPEM collect on the 8th and the 22nd of each calendar month.
4. If IPEM is still unable to collect the DD instalment from the IPEM member/RCT registrant’s bank account after the second attempt, then IPEM will inform the IPEM member/RCT registrant and ask the member/registrant to pay all the instalments due for the remainder of the year.
5. If an IPEM member then fails to pay all the instalments due within 30 days the IPEM Membership will be suspended. (Note this deadline will be extended to the 28th/29th February for IPEM membership if necessary to coincide with the IPEM grace rules, if applicable)
6. If an RCT registrant then fails to pay all the instalments due within 30 days the RCT registration status will be marked as lapsed.
7. If the IPEM membership is suspended, all additional products that depend on Membership of IPEM (Science Council & Engineering Council registration and Journal subscriptions) will be cancelled without refund.

Terms and conditions of payment of annual fees by Annual Direct Debit
1. IPEM will collect the Annual Direct Debit payment on the date shown on the Direct Debit advance notification from the IPEM member/RCT registrant’s bank account. For annual renewals these are normally on the 8th January. For other payments these are normally the 8th or the 22nd of the month.
2. If IPEM is unable to collect any Direct Debit payment from any IPEM member/RCT registrant’s bank account (Bounced DD collection) when it is due, then IPEM will re-present the Direct Debit collection on the next available collection date and inform the IPEM member/RCT registrant of this. The next collection is normally the 22nd January. For other payments these are normally on the 8th or 22nd of the month.
3. If IPEM is still unable to collect the DD payment from the IPEM member/RCT registrant’s bank account after the second attempt, then IPEM will inform the IPEM member/RCT registrant and ask the member/registrant to pay the fee by another method.
4. If an IPEM member then fails to pay within 30 days the IPEM membership will be suspended. (Note this deadline will be extended to the 28th/29th February for IPEM membership if necessary to coincide with the IPEM grace rules, if applicable)
5. If an RCT registrant then fails to pay within 30 days then RCT registration status will be marked as lapsed.

Confirmation

I have read, understood and accept the terms and conditions of paying my fees