New Member Manual Renewal If you a new member of MLACP and would like to pay for your membership with either a cheque or PayPal, please fill in and submit the form below. Personal Details Title (required) First Name (required) Last Name (required) Academic Qualifications CSP No. HCPC No. Choose Your Login Details User Name (required) Password (required) Contact Details Address Line 1 (required) Address Line 2 City (required) Region (required) East MidlandsEast of EnglandEasternNorth EastNorth WestNorthern IrelandScotlandSouth EastSouth WestWalesWest MidlandsYorkshire & The Humber Postcode (required) Phone (required) Fax Email Address (required) Website Associated Information Have you attended Medico – Legal Training (required) NoYes Have you ever written expert witness reports? (required) NoYes If yes, how long? N/A1-5 years5-10 Years10+ years Have you given evidence in court? (required) NoYes Any other relevant details about you Areas of Expertise Please tick the category which best describes your area of advanced knowledge and expertise (maximum 3 categories) AcupunctureHands, Burns and PlasticsElectrotherapyMental Health/Learning DisabilityManual Handling/Risk AssessmentNeurology/Head Injury/Spinal Cord InjuryOrthopaedicsMusculo Skeletal/Soft Tissue TherapiesOccupational HealthPaediatrics/Cerebral Palsy/Young DisabledAmputationHydrotherapy/Aquatic ExerciseCardio-Vascular/Respiratory DisordersSports InjuriesComplex Regional Pain SyndromeWomen’s Health/UrologyMEDCO Membership Level Type of Membership Full Membership is for Chartered Physiotherapists only - £45.00 p/yrAssociate Membership is for Allied health professionals eg. occupational therapists. - £45.00 p/yr Payment Type I would like to pay by: PayPalBACS Transfer
