BLSA Membership

If you are currently studying at Barts and The London School of Medicine and Dentistry, you are entitled to free BLSA membership of the Guild. If you would like to take advantage of this offer, please complete the form below.

Once you have applied for your membership you will be emailed by the Membership Secretary and asked to verify your QMUL email address in order to confirm your membership.

* indicates a mandatory field

Title*

Given Name*

Family Name*

HOME ADDRESS

Address #1*

Address #2

Town/City*

County

Postcode*

Country*

Tel. (home)

Tel. (mobile)

Email (personal)*

 

BARTS AND THE LONDON

Term Time Address #1

Term Time Address #2

Term Time Town/City

Term Time County

Term Time Postcode

QMUL Email*

Which course are you studying?*

Which year of study are you currently in?*
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