Interpretive Comments Registration

Interpretive comments registration

Interpretive Comments (Re-)Registration Form

UK NEQAS for
Interpretive Comments in Microbiology

The (re-) registration period is 1 April of the current year until 31 March in the following year. If you join part way through this period the charge remains £60.00.

Notes for completing the Registration Form

Participation is not restricted, however as the 'model' answers reflect current UK practice, participation is most appropriate for specialist UK practitioners, typically medical consultants or clinical scientists. Trainees in medical microbiology and virology are welcome to participate.

Please fill in the details below as requested.

I am*

a new participant

an existing participant

Participation ID: MA

Title

Forename:*

Surname:*

Position (e.g. Medical Consultant, Consultant Clinical Scientist, Trainee):

Sub-Dept:

Department:

Organisation/Hospital:*

Correspondence address Street:

Town / City:

Country:

Postcode:

Telephone:

Fax:

Primary Email*

This would normally be your work email which we will use for all communications

Secondary Email

This should be a complete separate personal email address which we can use in case your primary email fails

Subscription:*

Interpretive comments (£60)

Declaration

I wish to enrol in this scheme, which uses exclusively web-based access for submission of results and comments on the cases and access to reports, and have completed the details required.I am aware that there is a charge.I understand that a username and password will be issued to regulate access and that I am responsible for administering disclosure, access and changes of password.By checking the box next to ‘I agree to the declaration’, you are deemed to have signed the above declaration. Your application will not proceed unless you check the box.

I agree to the declaration*

A confirmation email of the information provided will be sent to your primary email address.

After submitting the form you will be directed to PayPal website to make the payment. Please use your PayPal login or use the PayPal Guest Checkout (to pay by debit/credit card).

Is someone else paying on your behalf?*

Yes

Payee Name:

First

Last

Payee E-mail:

Please enter the security code: