New Member Registration

HSC EMPLOYEES REGISTRATION FORM

HSC membership is open to HSC staff. Membership is pending while your registration is processed.

Surname:*
Forename(s):*
Title:
Position Held:*
Job Category:*
HSC Trust:*
Expiry Date (if temporary contract):

Work Address:
Dept/Ward:*
Line 1:*
Line 2:
Line 3:
Line 4:
Postcode:
Work Email:*
Telephone:
Extension:

Home Address :
Line 1:*
Line 2:
Line 3:
Line 4:
Line 5:
Postcode:
Home Email:*
Telephone:*
Extension:

I understand that the information contained on this form will only be used for the purposes listed in the following privacy notice and will be processed in line with the University's obligations under the General Data Protection Regulation. I confirm that the information provided in this form is complete and accurate.
I understand that in registering with the Healthcare Library I am agreeing the following terms and conditions of use.