Please register any changes to your membership details by completing this form and clicking on the authorisation icon.

Should you experience any problems please contact the records and Subscription Helpdesk on 0845 300 1666 between the hours of 9 am and 5.15 pm Monday-Friday

Required items are in RED

Membership number *
Can't find your membership number? This appears on your credential documents, membership card and other membership communications. It is defined as a letter (A-H) followed by five numbers (eg.B54321) or telephone the helpdesk on 0845 300 1666 Mon-Fri 9.00am-5.15pm
DfES number *
Your DFES number is required for verification purposes
Title Other	Mr  Miss  Mrs  Ms
Surname *
Forename(s)*
Date of birth *
Current home address
Corrected/new home address and any surname change
Line 1
Line 2
Line 3
New Surname
New Postcode* *Compulsory if Home address changed
Personal Email address	no email address confidential select an option OR type in personal email address below
Current home telephone number
Current school address
Corrected/new full school address. State if This refers to the school switchboard or office number, as opposed to your personal extension
Line 1
Line 2
Line 3
Corrected/new school postcode
Establishment email address**
**This should be the email address of your place of employment, rather than your personal address at this location
School telephone number

Your current employment terms: please complete all three sections *

1. Tick the box showing your timetable:
Up to an inlcuding 0.3	0.3 to 0.6	0.6 to F/T
2. Contractual employment terms:
permanent	Fixed term contract	supply
3. Anticipated duration of employment...
3 Terms	2 Terms	1 Term
A standard rate F/T subscription is applicable for members employed on a fixed term contract basis for more than two terms.

Are you leaving the profession or taking maternity leave?

I hereby authorise these amendments

Date*