Anaesthesia Associate (AA) Registration Form Name Title - Select -DrMrsMissMsMrProfessorOther First Name Last Name Email address Date of qulification (DD/MM/YYYY) University Hospital address If you are a qualified AA and would like to add your name onto the Managed Voluntary Register, please upload proof of your qualification below (please note, the register is updated on the last Friday of each month). Student AAs can register their details with the College and join our AA network by uploading proof of enrolment onto an AA training programme. Both student AAs and qualified AAs are also eligible to apply for RCoA Affiliate Membership and receive Logbook/CPD access. If you intend do this, please upload proof of enrolment or qualification. File upload Allowed types: txt rtf pdf doc docx Signature Please sign above using your mouse or finger (if using a touchscreen device). Date (DD/MM/YYYY) Confirmation Data Protection Statement The Royal College of Anaesthetists (RCoA) is fully committed to the principles of data protection, as set out in the Data Protection Act 2018 (C.12). The RCoA relies on legitimate interests as the lawful basis for processing of personal data. We process and maintain personal data about you so that we can manage your membership, provide you with appropriate products and services and share information with you about RCoA activities. We will only use your information for the purposes as described and will not pass on your details to other third parties unless you have given us consent to do so. We use appropriate organisational and technical measures to ensure that your data are secure and protected from loss, misuse and unauthorised access or alteration. You have the right to ask for a copy of the information we hold about you and to have any inaccuracies in your information corrected. If you have any questions about data protection or require further information, please email dpo@rcoa.ac.uk I have read and understand the College's data protection statement I would like to receive information about membership and other news relevant to Anaesthesia Associates from the Royal College of Anaesthetists I would like to receive information about events relevant to Anaesthesia Associates from the Royal College of Anaesthetists CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
