On-line Application

On-line Application Form

To be eligible to become a member of the Brighton & Hove PPG Network website you must be a member of a Brighton & Hove practice PPG or a representative of an organisation that attends PPG Network meetings.
To apply, please input your name (first name and last name), the name of the PPG/organisation you represent and your email address.
You also need to confirm your agreement to each of the statements below by ticking the boxes before each statement.

First Name & Last Name e.g. Jane Smith (required)

Which practice PPG or other organisation are you a member of? (required)

Email address (required)

Please confirm your agreement to each of the following statements by ticking the boxes before each statement.

I am a member of a Brighton and Hove practice PPG or a representative of an organisation that attends PPG Network meetings
I agree to my login details (name, username and password) being securely kept on this website to enable me to access the members' section
I agree to receiving email notifications about new member posts and replies to posts but understand that I may opt out of either at any time
I agree to receiving occasional emails when there is something new to respond to in the PPG Network members' section (such as a new poll)

N.B. After clicking ‘Send’ you will receive an email within about 24 hours which will give you your username and a provide a link to enable you to set a password. Once you have set a password (which you will need to remember!) you will be able to access the Members section of this website.

On-line Application Form

Please confirm your agreement to each of the following statements by ticking the boxes before each statement.

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