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Application to join the Younger Members' Network

Please enter your details below. Required fields are marked with a *
First Name:	*
Second Name
Family Name:	*
Company:
Job:
IBD Section:	*
Telephone:	*
Email:	*
Would you like to join the Younger Members Network?	*	Yes	No
Would you like to be a Younger Member Representative?	*	Yes	No
In order for us to tailor the Younger Members Network to your needs please indicate:
Your Key Areas of Interest
Events of Interest
Lectures of Interest
Activities
I confirm that I am under 35				*
I confirm that I am a member of the IBD				*

For further information please contact Jessica Clark at jessica.clark@ibd.org.uk