Please enable JavaScript in your browser to complete this form.Name *FirstMiddleLastPhone NumbersFirstLastEmail *Social MediaFirstLastWebsiteCompany NameRelevant QualificationsWhat is your current occupationNumber of years experience in Consulting *Years experience in MedTech *What motivates you to join the MedTech Professional Group?Paragraph TextSpeciality Areas of ExpertiseDisposables, consumables, general medical devicesBiomaterialsEquipmentManufacturingHealth ITQuality Assurance (GMP or ISO13485)IVDsRegulatory / LegalTestingImplantsSoftwareOther (Please use the following field to explainOther speciality areas of expertise.Declarations and Privacy StatementsI consent to my personal information being shared with the MDPG and its stakeholders for the purposes defined in the Terms of referenceI consent to my name and contact information being displayed on the MDPG websiteI certify that I am a consultant in the MedTech industryI confirm that all information provided is true and accurate and that if any of this information changes that the MDPG will be notifiedI have not been found guilty of any offence in terms of any of the regulatory bodies involved with MedTech in South AfricaI undertake to subscribe to the Terms of Reference and Code of Conduct of the MDPGI commit to being an active contributor to the group, preparing for and attending its meetings.The MDPG will collect, process and store your personal information in compliance with the Protection of Personal Information Act Once submitted, your application will be circulated to MDPG members. Membership will be confirmed at the next general meeting of the MDPG. You will be contacted by the Chairperson to confirm your membership or to request any additional informationNameSubmit