REGISTRATION FORM: Joint Programmes Board

The purpose of this form is to register you with the Joint Programmes Board. This will allocate a JPB registration number that must be noted and used for further communications.

Use the 'Send Registration Form' button at the end to submit your application. The form will automatically check some entries for validity before submission and request changes if errors are detected. You will be sent immediate confirmation by email that the submission was successful. Help notes for completion of form:

• Data from the form will not be submitted until you click the 'Send Registration Form' button at the end.
• A partially complete form will retain data while the browser window remains open.
• More details about the JPB Diploma in General Pharmacy Practice and the enrolment options can be be viewed via this Explanatory link which will open in a new window.

Please read the information about Data Protection on our web site.

Completion of this form will generate a 'JPB number' which you will need for future communcations and registration with your Academic Centre.

Personal Details
Title:	First name:	Other names:	Last name:
Mr Ms Mrs Miss Dr
	Select gender		DOB (dd/mon/yy)
	Male Female
email:		Confirmation will be sent to this email address.
email:		Please confirm your email and please ensure that it is exact.
	Roy.Pharm.Soc.GB.Registration	Year of Registration:
	No:
	Type of JPB application:	Standard entry applicant
		Interim entry applicant - Type Explanation

 

Centres and Lead Tutor
Academic centre		Hospital
Select from list Kings College London Kingston University Medway School of Pharmacy UoG School of Pharmacy London University of Brighton University of East Anglia University of Portsmouth University of Reading		Select from list Addenbrookes Hospital Amersham Hospital Ashford Hospital Barking Hospital Barnet Hospital Basildon University Hospital Basingstoke and North Hampshire Hospital Beckenham Hospital Bedford Hospital Bethlem Hospital Bexhill Hospital Bolingbroke Hospital Bracton Centre Hospital Brighton and Sussex University Hospital Brighton General Hospital Broomfield Hospital Buckland Hospital Central Middlesex Hospital Charing Cross Hospital Chase Farm Hospital Chelsea & Westminster Hospital Colchester General Hospital Conquest Hospital Hastings Crawley Hospital Cromer Hospital Crowborough Birthing Centre Darent Valley Hospital District Hospital District Hospital (QMST) Ealing Hospital East Surrey Hospital Eastbourne District General Hospital Eastman Dental Hospital Edgware Hospital Elizabeth Garrett Anderson and Obstetric Hospital Epsom General Hospital Erith Hospital Essex County Hospital Farnham Hospital Frimley Park Hospital Gateway Surgical Centre Goring Hall Hospital Gravesham Community Hospital Great Ormond Street Hospital London Green Parks House Hospital Guys & St Thomas Hospital Hammersmith Hospital Harefield Hospital Harlow Herts and Essex Hospital Haslemere Hospital Heatherwood Hospital Hemel Hempstead Genareal Hospital Hertford County Hospital High Wycombe General Hospital Hillingdon Hospital Hinchingbrooke Hospital Homerton University Hospital Hospital for Tropical Diseases Ipswich Hospital Joint Programmes Board Kent and Canterbury Hospital Kent and Sussex Hospital King Edward VII Hospital King George Hospital BHR Trust Kings College Hospital Lambeth Hospital Lewes Victoria Hospital Lewisham Hospital Lister Hospital London Bridge Hospital Lowestoft Hospital Luton and Dunstable Hospital Maidstone Hospital Maudsley Hospital Mayday University Hospital Medway Maritime Hospital Memorial Hospital Moorfields Eye Hospital Mount Vernon Hospital Site National Hospital for Neurology and Neurosurgery Newham General Hospital North Middlesex Hospital Northgate Hospital Northwick Park Hospital Norwich University Hospital Orpington Treatment Centre (Hospital) Orsett Hospital Oxleas House Hospital Papworth Hospital Pembury Hospital Petrborough District Hospital Princess Alexandra Hospital Princess Royal Hospital Princess Royal University Hospital Prospect Park Hospital Purley War memorial Hospital Queen Alexandra Hospital Queen Charlottes & Chelsea Queen Elizabeth Hospital, Woolwich Queen Elizabeth II Hospital Queen Elizabeth The Queen Mother Hospital Queen Marys Hospital Queen Victoria Hospital Queens Hospital Romford Roxbourne Hospital Royal Berkshire Hospital Royal Brompton Hospital Royal Free Hospital Royal Hospital Haslar Royal London Homoeopathic Hospital Royal National Throat Nose and Ear Hospital Royal National Orthopeadic Hospital Royal Surrey County Hospital Royal Sussex County Hospital Royal Victoria Hospital Southend Hospital Southlands Hospital Southwark PCT St Albans City Hospital St Bartholomews Hospital St Georges Hospital (Tooting) St Helier Hospital St Johns Hospital St Margarets Hospital St Marks Hospital St Mark's Hospital (Heatherwood) St. Marys Hospital St Marys Hospital Portmouth St Michaels Hospital St Peters Hospital St Peters Hospital St Richards Hospital Stamford & Rutland Hospital Stoke Mandenville Hospital Sussex Eye Hospital The Edith Cavell Hospital The Gordon Hospital The Harley Street clinic The Heart Hospital The Hillingdon Hospital The Lister hospital HCA The London Chest Hospital The Portland Hospital The Princess Grace Hospital The Queen Elizabeth Hospital Kings Lynn The Royal Alexandra Childrens Hospital The Royal London Hospital The Royal Marsden Hospital London The Royal Marsden Hospital Surrey The Royal National Orthopeadic Hospital The Wellington Hospital The Whittington Hospital The William Julien Courtauld Hospital University College Hospital University Hospital Lewisham Victoria Hospital Watford General Hospital West Berkshire Community Hospital West Middlesex University Hospital West Suffolk Hospital Western Eye Hospitals Wexham Park Hospital Whipps Cross University Hospital Willesden Hospital William Harvey Hospital Woodlands Hospital Worthing Hospital Wycombe Hospital - Other Hospital not listed -
		Other if not listed
LeadTutor	First name	Last name
Mr Ms Miss Mrs Dr Prof
	Lead Tutor email
	Confim email

Applicants are expected to have discussed the application with and have the agreement of their lead tutor.
Application submissions without a designated lead tutor will not be accepted.

Please include a comment if you feel you need to add further information.
		characters left.

 

 

Please click 'Send Registration Form' only once. Expect it to take a few moments for the site to respond.

After submission of this form completes you will receive a confirmatory email to the address you have given above.
If you do not receive this email, the submission of your details was not successful. In this case please try again.

If you continue to have problems please email the JPB at the address: admin@jpbsoutheast.org

Return to JPB Registration page