Registration for Membership in Association

Fill out the membership application form below to become a registered member of ASLP Malta.

Please note that the membership will be confirmed as soon as the payment is effected.

Payment can be effected using one of the following methods:

  • Cash to be given to Alexandra Ameen, Treasurer OR
  • Cheque payable to “Association of Speech-Language Pathologists”, and sent to Association of Speech-Language Pathologists, Malta Federation of Professional Associations, The Professional Centre, Sliema Road, Gzira GZR 1633, Malta, OR
  • Internet Banking (Bank of Valletta IBAN MT97VALL22013000000014911380012 OR HSBC IBAN MT71MMEB44750000000075150847001). A Standing Order to the above mentioned bank accounts can also be made using Internet Banking.

Membership Application Form

CPCM Registration Number *

Full Name *

Address *

Home Phone Number

Work Phone Number *

Mobile Number *

Email Address *

Membership Fee Type *

 

Signature *
(draw your signature in the area below)

 

The information provided in this application will be used solely by the ASLP in accordance with the Data Protection Act 2001. No other disclosures of the information will be made.