Application

Membership details

Providing your professional details helps us assess your application. Selecting an incorrect membership category will delay your application.

Membership category

Only required for overseas members. We suggest you upload your CV in either Word or PDF format.

Proposer details

Please choose an existing member of ACPGBI to support your application.

Please choose a second existing member of ACPGBI to support your application.

Create an account

This email address will be used for your logging into your account and as a method for the ACPGBI to contact you. It will not appear on either your public-facing or members-only profile.

Personal details

Name

Please enter using dd/mm/yyyy format (e.g. 12/05/1981)

This telephone number will be used as a method for the ACPGBI to contact you. It will not appear on either your public-facing or members-only profile.

Professional details

Please provide us with the details of the hospital you currently work at to help us assess your application.

Please select up to a maximum of 5 specialisms.

Please select up to a maximum of 5 specialisms. Hold CTRL on your keyboard to select multiple specialisms.

Qualifications (optional)

You will not be able to add multiple rows because Javascript is disabled in your browser.

Other surgical associations (optional)

You will not be able to add multiple rows because Javascript is disabled in your browser.

Directory preferences

The ACPGBI website has both a public-facing and members-only surgeon directory of its members. You can choose whether to opt-in / opt-out of either directory at any time.

Public-facing profile

The contact details you submit here will appear on your public-facing profile, and will therefore be accessible by all and indexed by search engines (e.g. Google)

Members-only profile

The contact details you submit here will appear on your members-only profile, and will not be accessible by all or indexed by search engines (e.g. Google)

Common details

The details you submit here will be shared on the directories you have chosen to opt-in to above.

Profile image

Providing a photo helps others identify you around the site.
Recommended image size: 500 x 500 (pixels)

Your biography will be used on the site to help others know more about you.
Don't miss opportunities to stay connected.

Please enter your full LinkedIn profile URL

Please enter your Twitter account handle. e.g. acpgbi

Mailing preferences

Set your communication preferences

By completing your application, you will automatically opt-in to receive appropriate communications from us based on the preferences you have set above.

Payment details

Choose your payment method