Membership Application

Membership of MASCIP is open to any healthcare worker or associated professional involved in the care or support of people living with SCI. MASCIP also welcomes applications from members and employees of SCI charities. Please complete our online application form and we will contact you shortly to confirm receipt of your application and provide you with your MASCIP Membership Number.

All mandatory fields are marked with an asterisk *

Title
First Name *
Last Name *
Work address *
City *
Country *
Postcode *

Telephone Number *

Ext.

Bleep
Email Address *
SCI Centre
Profession *
Areas of Specific Interest *

Address for correspondence if different from work address

Correspondance address
City
Country
Postcode