MEMBER REGISTRATION FORM

Please note: Persons registering as part of a corporate group, such as members of an institutional review board (IRB), are still required to complete this registration form

1. Personal Details

Surname Name

First Name

Middle Name

Telephone

Postal address

Post code

Physical address

2. Professional details

Profession

Institution

Position held

Physical address

Telephone

Official email

Postal address

Town

Post code

IRB Member

Yes No

Name of IRB

Subscription and Membership Fees

Student

Registration Fee - KSH 500

Annual Retention Fee - KSH 1,000

Individual

Registration Fee - KSH 1,000

Annual Retention Fee - KSH 2,500

Institutional (IRB)

20% discount is given on registration and annual retention fee for those who register as a corporate

Registration fee is payable to Co-operative Bank of Kenya

Account Name: Bioethics Society of Kenya
Account Number: 01134696005500
Branch: Nairobi Business Centre

Another form of payment is through M-pesa Paybill

Business Number: 400222
Account Number: 195463#YourName

Bioethics Society of Kenya

Bioethics Society of Kenya

MEMBER REGISTRATION FORM

Subscription and Membership Fees

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