Annual Membership Renewal Form

Caribbean College of Family Physicians – Jamaica Chapter (CCFPJC)

Welcome Back!

Thank you for continuing your membership with the Caribbean College of Family Physicians – Jamaica Chapter (CCFPJC).

Please complete this form to renew your annual membership. All information is kept confidential and used solely for membership administration.

MEMBER INFORMATION

Full Name

Email Address

Phone Number

CONTACT ADDRESS

Street Address

City

State / Province

Country

PROFESSIONAL DETAILS

Medical Council of Jamaica (MCJ) Registration Number

PRACTICE INFORMATION

Involvement in General / Family Practice

Full-Time Part-Time

Current Position / Occupation

Parish of Practice

MEMBERSHIP CATEGORY & RENEWAL FEES

Please select your current membership category for renewal.

Membership Categories (Annual Renewal Fees)

ACTIVE CHAPTER MEMBER

Renewal Fee: J$6,500

ACTIVE DIRECT MEMBER

Renewal Fee: J$6,500

SEMI-RETIRED MEMBER

Renewal Fee: J$4,500

ASSOCIATE MEMBER (Interns & Residents in Family Medicine – within 4-year limit)

Renewal Fee: J$4,000

SUSTAINING MEMBER (Health professionals allied to medicine)

Renewal Fee: J$4,500

SPECIALIST / CONSULTANT (Non-Family Medicine)

Renewal Fee: J$6,500

RETIRED & HONORARY MEMBERS

Renewal Fee: Free (Confirmation may be required by the Secretariat)

STUDENT MEMBER (Up to Internship)

Renewal Fee: Free (Proof of student/intern status required)

CORPORATE MEMBER

Please contact the CCFP Secretariat for renewal arrangements

Upload Supporting Documents

Max 10 MB

DECLARATION

I confirm that the information provided in this membership renewal form is accurate and complete to the best of my knowledge.

If you require clarification, are unsure of your membership category, or belong to a category requiring Secretariat approval, please contact the CCFP Secretariat at 876-946-0954 or 876-517-6636

💳 Payment Required

This form requires payment to process your submission.

Payment Amount (JMD)

Minimum amount: JMD J$4,000.00