Pharmaceutical Membership | Health Communications | HCA UK

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Choose the size of the organisation

£1500.00

ex.

VAT

Organisation

Company details

Company name:*

Phone:*

Fax:

Website URL (including http(s)://):*

Primary Business Activity:*

Where did you first hear about becoming an HCA member?:*

Address line 1:*

Address line 2:

Address line 3:

City:*

Post code:*

Reasons for joining:*

Accounts contact name:*

Accounts email address:*

PO Number (optional):

Accounts invoice address (if different to company address):

Invoice Address line 1:

Invoice Address Line 2:

Invoice Address Line 3:

Invoice City:

Invoice Post code:

Primary contact

This should be the person within your department or company who agrees, on behalf of your company, to abide by the HCA Code of Conduct* and to whom key HCA correspondence and literature should be sent.

First name:*

Last name:*

Business phone:*

Email address:*

Job title:*

Secondary contact

The HCA operates a web-based members' contact database that ensures that HCA communications, such as training event alerts and newsletters, reach the correct people within your organisation. Please nominate someone who can manage this.