Apply - King's College Hospital Nurses' League

Surname *

First Name *

Previous name(s)

Address *

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City

State / Province / Region

Postal Code

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Permanent address to send the annual journal to *

Address Line 1

City

State / Province / Region

Postal Code

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Personal Email Address (not NHS) *

Personal phone number

Membership of King’s College Hospital Nurses’ League (KCHNL) is open to Registered Nurses/ Midwives who meet one of the following criteria.

Please tick the box to confirm which category your application comes into and give appropriate dates: *

I did my pre-registration training at King’s College Hospital
I completed the majority of my pre-registration clinical experience at King’s College Hospital during a course at the Florence Nightingale School of Nursing and Midwifery, King’s College London, London South Bank University or another Higher Education Institutions associated clinically with King’s College Hospital
I am currently employed at King’s College Hospital NHS Foundation Trust and have been in post for at least a year

Please specify appropriate dates for whichever criteria you ticked:

I wish to become a member: *

I wish to become a member of the King’s College Hospital Nurses’ League and will abide by the constitution (see link below).

Click here to view the constitution.

Please choose method of payment below: *

BACS payment of £50 to cover 5 years membership*
Print completed form and send to Mrs V Tubbs**

*Lloyds Bank, account name: KCHNL, sort code: 30-96-09, account number: 01719997. Please include your name as the reference.

**3 Thorpe Close, Orpington, BR6 9RG with a cheque for £50 made payable to KCHNL (enclose an sae if you require a written receipt).

To comply with the General Data Protection Regulations (GDPR) in force after May 2018, King’s College Hospital Nurses’ League requires you to complete the form below so you can receive communication from the League, including receiving the Journal. Please tick all relevant boxes:

I consent to the King’s College Hospital Nurses’ League contacting me by post - please note this box must be ticked if you wish to receive the Nurses' League Journal each year
I consent to the King’s College Hospital Nurses’ League contacting me by email
I consent to the King’s College Hospital Nurses’ League contacting me by phone

Data retention *

I understand that I may opt out at any time by informing King’s College Hospital Nurses’ League in writing, and without giving a reason.

Data sharing *

I understand that my personal data will not be shared with any third parties

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Application for Membership of King’s College Hospital Nurses’ League.

Membership of King’s College Hospital Nurses’ League (KCHNL) is open to Registered Nurses/ Midwives who meet one of the following criteria.

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Download a printable version of this form (Word)

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