WIP Associate Member
Please be aware that this membership application is quite comprehensive and will take a few minutes to complete. You will be asked questions about yourself, your interests and where you found out about World Institute of Pain. In order to join online you will also need your credit/debit card details to hand.
The above Fee Amount Due must be paid by debit/credit card through Authorize.net as part of the registration process.
(Please re-register if a previous application was not completed)
By completing the application form, you agree to be bound by any rules or terms and conditions that may apply.
Data Privacy & Security
We respect your privacy and will never knowingly disclose any of your details to any third party without your permission unless we are required to do so in order to comply with a legal notice served under UK law.
Data Protection Act: This group abides by the principles of the Data Protection Act 2018 and the General Data Protection Regulations (GDPR). Any queries about the “Basis of Processing” or other related matters under GDPR regarding this data must be directed to the management of the group.
By completing this form you confirm that you consent (or have obtained the consent of the person concerned) to have these registration details recorded in a database for the purposes of Group administration.
This information will be saved such that it will only be visible to the management of this Group. If you wish your details to be made available to the other members of this Group, you must arrange this with the management of the Group or set such permissions yourself in the system security function (if made available to you).
The World Institute of Pain® is exempt from federal income tax under section 501(a) of the Internal Revenue Code as an
organization described in section 501(c)(3).
Federal ID No. 95‐4579119