Reduced Rate Subscription Application Form

You may be eligible for the reduced rate subscription if your GROSS income from ALL EMPLOYMENT SOURCES (including additional basic pay, High Cost Area allowance and any other monthly allowances or payments, including regular on call or overtime) amounts to LESS than the current AfC Point 16 Band 5 of £28,407 .

If you believe you qualify for the Reduced Rate Subscription, please provide your details below:

Title

Full Name

Membership Number

Mobile Number

Work Telephone Number

Address

Post Code

Date of Birth

Email Address

Workplace Name

Work Address

Post Code

Department

Job Title

Hours worked per week

Gross Annual Income

PROOF OF EARNINGS MUST BE SUPPLIED IN THE FORM OF SCANNED COPIES OF YOUR LAST 3 PAY ADVICES

File uploader

Please select a file

File uploader

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File uploader

Please select a file

I declare that the above is accurate

Consent to process

I give consent to the Society of Radiographers to utilise my information in order to assess my eligibility for the reduced rate and to retain the information with my membership record.

Signed (full name)

Date

You must reapply for this reduced rate every year, failure to do so will result in your subscription automatically reverting to the full rate subscription from October.

You WILL BE notified only if you are NOT ELIGIBLE for this rate.

Data Protection Act

In this notice, "We", "Us" and "Our" mean the Society of Radiographers Limited, registered in England and Wales, company number 00169483 and the College of Radiographers, registered in England Wales, company number 01287383. Our registered office is 207 Providence Square, Mill Street, London SE1 2EW.

We will use the data supplied by you for the purposes of processing your application. Our lawful basis for processing personal information is your consent. We will retain all information you submit as verification of your participation.

Data is collected and stored on our website and membership database, made available to Us as account holders; all information collected is kept confidential and secure. Any personal data which are submitted to Us will have appropriate safeguards applied to ensure compliance with the Data Protection Act 2018 and summarised in our privacy policy.

For detailed information about how we use your information please see our full privacy policy.

If you have any questions or concerns about Our use of your personal data then contact our Data Protection Officer. Alternatively, you may wish to liaise with the Information Commissioner's Office (ICO).

Reduced Rate Subscription Application Form

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