PeMSAA-UK
Membership Application Form
Surname
First Name
Year of Entry to Peradeniya Medical School
Email Address
Postal Address
Membership Fee

General membership: £25 a year

Associate Membership: £15 a year

Life Membership: £200 (Once in a lifetime payment)

Associate Life Membership: £100 a year


Please choose the membership type you would like
Membership
Associate Membership (See membership Information for the criteria)
Life Membership
The Bank Account details for online money transfer and setting up Standing Order:

Bank Sort Code: 20-45-45

Account Number: 60275476

Name of Account: PeMSAA UK
Please set up a standing order for the payment of membership annually to the above account.

If you are applying for Life Membership, please transfer £200 only to the above account. You have to do this only once and then enjoy the membership for the rest of your life.

If you want to pay by cheque, please use the application form in pdf format available on the Membership Information page and to get the address to post the application and cheque, email pemsaa.uk@gmail.com.
Please indicate How you would like to pay the membership fee:
Online transfer of Membership Fee of £25 or £15
Setting up a Standing order for annual payments of £25 or £15 (Preferred)
Life Membership Payment of £200 or £100
I would like to post a cheque