Retirement Declaration Retirement Declaration Your DetailsFirst Name(Required)Last Name(Required)Retirement Date(Required) DD slash MM slash YYYY Email(Required) I am:(Required) Registered without a licence to practice Registered with a licence Confirmation I confirm that I retired from the practice of Forensic & Legal Medicine on the date provided and that I am no longer working in this specialist field.Declaration I declare that the information contained in the application for a reduced subscription to the Faculty of Forensic & Legal Medicine is true, accurate and complete to the best of my knowledge. I acknowledge that if the information I have provided should change I undertake to inform the Faculty immediately and pay, pro-rata, any subscription fee which is due.Date(Required) DD slash MM slash YYYY
