Students and Junior Doctors seeking membership for the first time, please join using the Student & Junior Doctor membership form. 1 Personal information2 Contact details3 Membership & Payment TitleDrMrMrsMsProfFirst name*Middle nameSurname*Preferred nameDOB (dd/MM/YYYY)*GenderMaleFemaleMedical qualifications and surgery detailsBasic medical qualifications*MBBSMBBCHBMEDFRACSFACRRMFRANZCOOtherYear study will be completedOther qualificationsYear graduatedPlace of studySurgery nameSurgery phoneHospital 1Hospital 2ABNProcedural practice Anaesthetics Surgery Obstetrics A&E / on-call Other Other: please provide details of your procedural practiceOn call rate (eg 1:3)Years in rural practice Contact detailsPreferred phone contactMobileCommunication via email? Yes, I am happy to receive communications from RDA NSW via email Preferred postal details* Street Address Address Line 2 City NSWNTACTQLDVICWASATAS State Postcode Email* Enter Email Confirm Email Username*Enter a username for logging in to access member content on this website (we recommend your first and last name with no spaces)Password* Enter Password Confirm Password Strength indicator RDA membership$720 Ordinary membership (financial year subscription, includes GST) $362 Membership for medical spouses of full financial members, registrars and part-time doctors (financial year subscription, includes GST) $99 Retired rural doctor or Junior Doctor Membership . NOTE: first year Junior Doctor membership is free - sign up here (financial year subscription, includes GST) Free Student Membership (for the duration of study) includes GST Please note: RDAA receives $250 of the full membership subscription fee (including GST).Please select the membership type you would like to apply for:*Ordinary membershipMembership for medical spouses, registrars or part-time doctorsRetired or Junior doctorsTotal $ 0.00 Credit Card* DiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20172018201920202021202220232024202520262027202820292030203120322033203420352036 Expiration Date Security Code Cardholder Name NameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle AJAX powered Gravity Forms.