Apply for Membership

Complete the form below to apply. Your application goes to the Membership Committee for review, and you'll be notified in writing within 30 days, per Article 5 of the Constitution.

1 Account & Contact Details

How we'll reach you about your application.

Full Name

Email Address

Mobile Number

Preferred Communication

2 Personal Information

All optional except where marked, but helps the Committee process your application faster.

Date of Birth

Gender

Nationality

Region

District of Origin

District of Residence

Postal Address

Physical Address

Emergency Contact Name

Emergency Contact Phone

3 Professional Information

Membership Category

Professional Qualification

Institution Attended

Graduation Year

Registration Number

Practising Licence Number (if applicable)

Employer

Facility Level

Employment Sector

Current Position

Years of Experience

Areas of Clinical Interest

4 Document Upload

All optional except Passport Photograph. Accepted: JPG, PNG, PDF — max 5MB each.

Passport Photograph

National ID

Academic Certificates

Degree Transcript

Professional Registration Certificate

Practising Licence (if applicable)

Curriculum Vitae (optional)

5 Declaration

I confirm that the information provided in this application is accurate to the best of my knowledge.

I agree to abide by the GMCOA-U Constitution and Code of Conduct.

I consent to the processing of my personal data in accordance with applicable data protection laws.

Membership Application

1 Account & Contact Details

2 Personal Information

3 Professional Information

4 Document Upload

5 Declaration