Membership Form

Select your membership: *

Professional Membership – Doctors & Healthcare Professionals

Family Membership – Parents & Families

Corporate Membership – Organisations & HR Professionals

Researcher / Academic Membership

Student Membership

Area of Interest *

For Doctors / Healthcare Professionals

Specialisation:

Professional Registration No. (optional):

What are you interested in?

Organisation Name:

Organisation Type:

IT / Technology

Healthcare / Hospital

Education

Manufacturing

Financial Services

Consulting

Other:

Approximate Employee Strength:

<100

100–500

500–1,000

1,000+

Interested in:

Employee Cognitive Wellness

Neurotechnology Awareness

Corporate Workshops

Employee Assessment Programme

Research & Innovation Partnership

Institutional Partnership

Number of Family Members:

Age Group of Child/Children:

6–10 years

11–14 years

15–18 years

18+ years

Primary Interest:

Attention & Cognitive Assessment

Learning & Cognitive Development

Neurofeedback

Cognitive Wellness

Parent Awareness Programme

I would like to receive information about SIU BehaveNeu workshops, research programmes, events and membership activities.

I agree to the SIU BehaveNeu membership terms and privacy policy. *

Membership Form

1. Membership Category

2. Personal Details

3. Professional Information

For Doctors / Healthcare Professionals

4. Membership Objectives

5. Organisation Details – Corporate Members

6. Parent / Family Members

7. Communication Preferences