Applying to join the Gay and Lesbian Association of Doctors and Dentists

This is the first of two forms you will need to complete to join GLADD. After this one, you will be directed to a standing order mandate which we ask you to print out, sign and return to us.

This is the form to join GLADD as a qualified doctor or dentist. If you wish to join as a student member, click here.

Please complete the form carefully. In order to ensure you have not left out any important information, please use the [TAB] key to move between each part of the form. All fields marked with a * are required. All the information you provide is treated in the strictest confidence, and never released to a third party without your permission.

We automatically subscribe new members to a mailing list which keeps you up to-date with what the committee's organising. We also run a private members' web forum, GLADDM, using the Ning social networking system. To get the most out of GLADD, we'd recommend you let us invite you to this group. You can opt out by selecting the tick box below.

I would like to pay by standing order (the default option). I understand that this significantly reduces the amount of administrative work GLADD has to do, and setting up a standing order takes no more time than writing a cheque.

I would like to pay by cheque. Please send me an invoice for my membership of GLADD for the first year. I understand that will include a £15 surcharge to cover the additional administrative costs incurred by GLADD.