The Society for Cognitive Rehabilitation
IMPORTANT!
Are you currently, or were you previously, an SCR member?
If so, you should try to log in here first, or contact SCR if you have forgotten your details.
If you sign up again on this page as a new member, you may duplicate your record.
Step 1 - Complete the form
You can join the SCR by completing the membership details below.
Then use the Submit & Review button at the foot of the form.
Title
First Name
Last Name
Home Address1
Home Address2
Home City
Home State/County
--Select Home Country below--
Home ZIP/Postcode
Home Country
Home Phone
Home Email
Organisation
Work Address1
Work Address2
Work City
Work State/County
--Select Work Country below--
Work ZIP/Postcode
Work Country
Work Phone
Work Fax
Work Email
Preferred Contact Home Work
Cell Phone/Mobile Phone
Discipline
If you cannot find a suitable category above, please enter a Discipline in the box below
Professional Status
Specialities
Visible for
member search
Tick this box if you want to be visible to other members.
Only your Name, general location, Discipline & Professional Status will be shown.
Your address, email and phone/fax will not be shown to other members.
International members only:
Do you want to belong to
the Dutch branch of SCR?
No   Yes
Username
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(between 8 and 22 characters)
Password
Choose a password
(minimum 8 characters in length)
Confirm password
Confirm your password