If you experience any issue whilst filling this form, please email events@rcr.ac.uk

Thank you for your interest in the position of Clinical Radiology RCR REAL Faculty Medical Member. Please submit your form no later than 5th December 17:00 GMT and we will notify successful candidates no later than 9th December.

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* 1. Title (Dr, Prof)

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* 2. Full Name

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* 3. Email address

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* 4. Please upload your CV, highlighting relevant experience

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* 5. Please explain why you would like to be Clinical Radiology RCR REAL Faculty Medical Member (250 words max)

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* 6. I confirm I am a Member or Fellow of the RCR by examination (no minimum period as a Fellow is required), resident in the United Kingdom, hold a current licence to practise with the General Medical Council (GMC) and I am in active clinical practice.

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