British Geriatrics Society by gabyion

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									                              British Geriatrics Society
                            Membership Application Form
 Membership Office, British Geriatrics Society, Marjory Warren House, 31 St John’s Sq.
                             London EC1M 4DN, England

1. All Applicants

     Surname
 Full Forenames
         Title
    Telephone
Mailing Address




     Post Code                                         Country
  Email Address
  Male                     Female                          Date of Birth
Present NHS Status/Academic
Post
Date of Appointment
Speciality
GMC No. (if applicable)

I hereby apply for membership in the British Geriatrics Society and agree to abide by the Articles and Byelaws of
the Society.


Signature                                                     Date




2. Non-consultant grade applicants

Current grade of post
Dates of CCT (if applicable)


I declare that I am eligible to pay the reduced subscription fee as I am a junior doctor in Specialist Registrar
Grade or below. I understand that I am to advise the BGS once I am appointed to Consultant Grade.
 Signature                                                            Date




3. Unemployed Applicants Only

Date of last employment                             Grade of last employment

I declare that I am eligible to pay the reduced subscription fee as I have been unemployed for six consecutive
months. I understand that I am to advise you once my employment status changes.


 Signature                                                            Date




4. All applicants: Category of Membership (please tick appropriate box in the first column)

                                                                                               £176 (£156 if
           Cat 1: Consultants in the United Kingdom                                            paying by direct
                                                                                               debit)
                                                                                               £105 (£85 if
           Cat 2: Trainees, Research Fellows and Staff Grade Physicians, Clinical
                                                                                               paying by direct
           Assistants, Associate Specialists
                                                                                               debit)
           Cat 3: General Practitioners, Retired doctors, SHOs, Scientists, Nurses,            £ 90 (£70 if
           Nurse Consultants, Therapists and Pharmacists – wishing to receive the              paying by direct
           Age & Ageing journal                                                                debit)
           Cat 4: Overseas - doctors permanently resident outside the UK (including
                                                                                               £ 80
           the Republic of Ireland)
           Cat 5: Nurses, Nurse Consultants, Therapists, Pharmacists and retired               £46 (£26 if
           doctors (this category does not receive the Age & Ageing journal)                   paying by direct
                                                                                               debit)




5. For completion by the Proposer and Seconder (may be a non-medical person,
provided that they are a member of the BGS):

Proposer's Name                                                    Address


 Regional Branch

I regard the candidate as a suitable person for membership in The British Geriatrics Society, of which I am a
member.


 Signature                                                            Date
Seconder's Name                                                    Address



I regard the candidate as a suitable person for membership in The British Geriatrics Society, of which I am a
member.


 Signature                                                            Date




6. Overseas Applicants Only:

Present Appointment                                          Speciality

Reason For Seeking Membership of the BGS:




7. For applicants without access to a BGS member, the following section should be
completed by a GP, Consultant or Nursing Home Manager

   Proposer's                                                 Hospital/Home
     Name                                                       Name and
                                                                 Address



 Position held in
 hospital/ home:

Proposer's evidence in support of the candidate (this should include the candidate's
interest in, and contribution to geriatric medicine):




I regard the candidate as a suitable person for membership in The British Geriatrics Society


 Signature                                                            Date
                                  BRITISH GERIATRICS SOCIETY
                                    For better health in old age

Membership Office, British Geriatrics Society, Marjory Warren House, 31 St John’s Sq.
                            London EC1M 4DN, England

    Tel: +44 (0)20 7608 8574 Fax: + 44 (0)20 7608 1041 Email: membership@bgs.org.uk


                               MEMBERSHIP APPLICATION FORM


The British Geriatrics Society is:

    A professional learned Society of over 2,500 medical practitioners, scientists and those in
     professions allied to medicine who have a special interest in the prevention and management of
     illness in old age;
    the sole British medical society devoted to medicine and research into the health care needs of an
     ageing population;
    a registered charity which encourages and develops a more positive public awareness of the
     medical aspects of ageing and the problems created by diseases that commonly affect older
     people;
    an organisation whose membership includes:
    consultants in geriatric medicine
          o general practitioners
          o consultants in allied specialties and community medicine
          o junior doctors training for a career in geriatric medicine
          o overseas doctors who wish to maintain professional links with British geriatric medicine
          o those who hold higher degrees and are engaged in research in ageing and health
          o those in professions allied to medicine (nurses, therapists and pharmacists) with a special
              interest in the care of older people.

Activities:

    Promotes high standards in geriatric care;
    Promotes research into ageing and the diseases of old age;
    Promotes the teaching of geriatric medicine at all levels and to all disciplines;
    Liaises with other United Kingdom and international bodies concerned with the health and welfare
     of older people;
    Publishes Age & Ageing, the bi-monthly scientific journal of the Society;
    Provides a bi-monthly newsletter, containing general information and current events, publications,
     conferences and details of meetings;
    Convenes bi-annual scientific meetings held in various venues throughout the UK;
    Supports a special group for doctors in training;
    Awards prizes and bursaries to encourage interest in geriatric medicine;
    Supports a regional network of branches with regular meetings;
    Maintains links with other national as well as international gerontological societies;
    Provides a forum for debate on matters relating to geriatric medicine through the democratically
     elected hierarchy of committees.
Categories of Membership:

The categories of membership and subscription fees for 2009 are set out on page 2.

Please do not send payment with this form. Your application for membership will be considered by the
BGS United Kingdom Management Committee and you will be formally invoiced upon ratification of
your membership.

The subscription year runs from January to December. Subscription rates are subject to annual
change when they are approved by the Annual General Meeting. The current rates are shown above
apply to the year January – December 2009. Subscriptions are fully tax deductible in the United
Kingdom.

Payment in settlement of an invoice, may be made by cheque, credit card mandate (AMEX, Visa,
Mastercard or Switch). There is also a secure online payment facility at www.bgsnet.org.uk. The online
facility does not accept AMEX payments. A £20 discount applies to the rates if the member pays by
direct debit (not applicable to category 4). In other words, if a consultant pays by direct debit, the
subscription would be £156 and is fully tax-deductible.

BGS MEMBERSHIP ENTITLES MEMBERS TO:

    Receive free of charge, the Age & Ageing journal (£271/$542/€407 on the open market) - this
     entitlement is available to membership categories 1-4 only.
    Attend the Society’s bi-annual Scientific Meetings at a discounted registration fee;
    Attend regional meetings and participate in regional activities; and
    To contribute, via Regional and national representatives, to debates and decisions affecting local
     and national policy regarding the health care of older people.


Please note that the BGS operates a strict privacy policy with regard to its members’ contact details.
We do not pass your details on to third parties outside the British Geriatrics Society. We do publish an
annual handbook which includes a directory of members. This is available to members only. In order
to be included in future issues of the handbook, you will need to give your express permission and a
form will be sent to you in your welcome pack for you to return to us for this purpose.


    INSTRUCTIONS FOR APPLYING FOR MEMBERSHIP OF THE BRITISH GERIATRICS SOCIETY

Please complete the appropriate sections on pages 1 - 3 of the Application Form; obtain endorsement
of a proposer and seconder who are currently members of the Society; detach form and return to:


      Membership Office, British Geriatrics Society, Marjory Warren House, 31 St John’s Sq.
                                  London EC1M 4DN, England

    Tel: +44 (0)20 7608 8574 Fax: + 44 (0)20 7608 1041 Email: membership@bgs.org.uk

								
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