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Membership of the iCMLf - Membership Form
  1. Through the work of the iCMLf your support will further the progress towards best possible management for CML patients wherever they reside.

    Please fill out the following form to become a member of the iCMLf. Fields marked with an asterisk (*) are required.

  2. (*)
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  3. Name:(*)
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  4. Institution/organisation:(*)
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  5. Department
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  6. Telephone
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  7. Country:(*)
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  8. E-Mail address:(*)
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  9. Membership fee(*)
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  10. We suggest a membership fee of USD 100. A lesser amount can be contributed if full payment is difficult at this time (minimum USD 10). Membership fees are paid annually.

  11. Donate to Specific iCMLf Programs

    As a member of the iCMLf you can also choose to directly contribute to the iCMLf’s most important programs. With your help, we can significantly increase the number of physicians, scientists and patients who are supported through these programs. The entirety of your donation will be applied to the designated program(s) of your choice. This contribution will not be used for administrative costs, which are covered by the iCMLf.
  12. Additional donation(*)


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  15. Contributions of $500 or more will be specifically acknowledged on the iCMLf website and annual report. iCMLf members contributing over US $1,000 in any one donation will be recognised as a Patron of the Foundation. Thank you for this additional support!

    Payment Methods

  16. (*)


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  17. Please include your full name and the words "iCMLf Membership" as a reference for all electronic payments.
    Direct Deposit:
    US$ account:
    Bank name: HSBC
    Bank address: 152 Portobello Road London W11 2EA
    Account number: 72004666
    Sort code: 40-05-15
    SWIFT/BIC: MIDLGB22
    IBAN: GB09MIDL40051572004666

    UK Pounds Sterling account:
    Bank name: HSBC
    Bank address: 152 Portobello Road London W11 2EA
    Account number: 21524003
    Sort code: 40-05-08
    SWIFT/BIC: MIDLGB22
    IBAN: GB47MIDL40050821524003

    Credit Card:

    Please click here to use your credit card to pay your membership fee    . You do not need a PayPal account to make the payment - just click on "Don't have a PayPal account?" when the PayPal page opens.

    Questions

    Email – nicola.evans@cml-foundation.org

    The iCMLf is a charitable organisation registered in England and Wales.
    Charity number 1132984.
    Donations are tax deducible as allowable by law.

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    • © iCMLf International Chronic Myeloid Leukemia Foundation

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