Become A Member of the BSIR

Please complete the form below to register to become a member of the BSIR.

Fields marked with a * are required

Type of membership required: *

Account Details

Primary Email Address *

This email will be shared with other members through find a member and will be your user name for login.

Password *

Confirm Password *

Personal Details

Title *

Given name *

Surname *

Date of birth *

Gender *

Personal Address Details

Address 1 *

Address 2

Address 3

Town *

Country *

Postcode *

Other Personal Details

Referring Member's Email Address *

Please enter the email address of a member that will support your application.

Head of Training's Email Address *

Please provide the email address of the person responsible for your training

Qualifications *

Ccst status *

Anticipated CCST Date *

Job Title *

Hospital Address Details

Hospital *

Hospital department *

Hospital address 1 *

Hospital address 2

Hospital address 3

Hospital town *

Hospital country *

Hospital postcode *

Hospital telephone *

Contact Details

Telephone *

Home email address *

Work email address *

Preferred mailing address *

Please tick if you would like to be added to the BSIR mailing list

Upload a Profile Picture:

Please tick to confirm you have read and are happy with the terms of use and privacy policy available here.