This form is for applying to be a member of the RCPE Senior Fellows Club. To apply, please complete and submit the form below. Current Consent Your details Member details Confirmation Complete Data consent We are committed to ensuring that your privacy is protected. The information you provide here will only be used for the purposes of processing and approving your membership request. In accordance with data protection regulations we require your consent for this. The data for successful applicants will be held on our membership system and will thereafter be processed on the basis of 'legitimate interests' for the duration of your membership. Further information is available within our Privacy Notice. I understand that RCPE will store and use the data I submit here for the purpose of processing my membership application Leave this field blank