Join us - Affiliates

First Name *

Last Name *

Address Line 1 *

Address Line 2

Address Line 3

City

State/Province/Region

Zip/Postal Code

Country *

Phone *

Email *

Medical Registration Number

Consent for storing submitted data *

Yes, I give permission to store and process my data

Terms and Conditions *

I have read and agree to the BMA's Terms & conditions

Marketing

To receive relevant informaton on your membership benefits, please tick to opt-in. Your information will be processed in accordance with the BMA's privacy policy. You can change your contact preferences at any time.

Privacy Policy *

You consent to the BMA processing your personal data for the purposes of operating your membership and offering you benefits as well as for pursuing BMA’s legitimate interests and any other purposes referred to in the Privacy Policy save for personal data that the BMA is required or authorized by law to collect, the provision of such personal data is voluntary, but should you not provide all the required information then you may not be able to become a member of the BMA or fully enjoy the benefits that the BMA has to offer. You further agree to the BMA sharing your personal data with third parties for these purposes. You also understand and agree that your personal data may be transferred to and accessed from locations outside of the jurisdiction in which you live and you hereby agree to such transfers. For more information on how BMA processes your personal data and your rights you should refer to the Privacy Policy. If you do not agree to the Privacy Policy, you must cease using our services immediately.

Join the BMA