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Thank you for expressing an interest in becoming a RCSLT Research Champion. 

If you have not done so already, we recommend you read the Research Champion Mission and Vision statement, before continuing. 
If you would like to register, please take a few moments to provide us with a few details to ensure you get the most from being a member of the network, as you can. 

If you are already a research champion, and are using this form to update your details, please indicate this at the bottom of the page. 

By completing this form, you are providing your consent for your details to be stored by the RCSLT, and are opting in to receive communications specifically targeted to Research Champions. If you have any concerns or issues with how your data will be used, please email 

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* 1. What is your full name?

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* 2. What is your RCSLT membership number?

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* 3. What is your email address?

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* 4. Please select which applies to you:

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