MEDILINK EAST MIDLANDS

+44 (0) 115 822 3154

info@medilinkem.com

  • COMMERCIAL OPPORTUNITIES, FUNDING & INVESTMENT, RECRUITMENT, TRADE MISSIONS AND MUCH MORE...
    TO VIEW ALL OUR LATEST OPPORTUNITIES PLEASE CLICK HERE
  • FIND OUT WHAT’S HAPPENING IN THE REGION AND HOW IT MIGHT AFFECT YOU AND YOUR ORGANISATION...
    TO DOWNLOAD THE LATEST PODCAST PLEASE CLICK HERE
    

Online Membership Form



Please note: This form cannot be saved so please ensure you have all the necessary information available to complete the application.

Company Information

Company / Organisation Name

Department / Group

Address




Post Code

Contact Number

Email Address

Website

Twitter Handle

Description of Business Activity
Max 25 words:

Number of Employees

Please select membership type:


*Life Science organisations (or business units of larger companies)
**For non-Life Science organisations

I confirm that by completing this form, I agree that our organisation will become a member of Medilink East Midlands.

You will be invoiced once the form has been received and processed by Medilink East Midlands.

Person completing the form:

First Name:

Last Name:

Position:

Email Address:

Telephone:

Date:
RadDatePicker
RadDatePicker
Open the calendar popup.

Main Contacts’ Details: (please provide the details for all of those in your organisation who would like to receive our e-newsletter)

Important: You must add at least one contact. To do this, complete the four boxes below and click 'Add contact'.


First Name:

Last Name:

Position:

Email Address:

Telephone:

Add Contact

Remove Selected Contact