The British Society for Restorative Dentistry
Please reply to:
Admin Secretary:
Email:
Address:
Tel:
Fax:
Miss Becky Rowe
Becky.Rowe@UHBristol.nhs.uk
General Manager’s Office
3rd Floor, Chapter House
Bristol Dental Hospital
Lower Maudlin Street
Bristol
BS1 2LY
0117 342 4400
0117 342 4443
Hon Treasurer:
Email:
Miss Susan Hooper
susan.hooper@bristol.ac.uk
Registered Charity
No. 258139
Please ask your Head of Department to sign this form. Please then return it to:
Ms Becky Rowe, BSRD Administrative Secretary, at the above address
Entitlement to Postgraduate Student Membership (Full time students only)
(SHO / SpR appointment without PG registration does not entitle PG membership)
I (Head of Department) ......................................................................confirm that:
Name (PG student) ...............................................................................................
Of Address...........................................................................................................
.............................................................................................................................
.............................................................................................................................
.............................................................................................................................
is a registered Full Time Postgraduate Student for the academic year: ...............
and is therefore entitled a reduced subscription rate
and (when advertised) preferential rates for conferences.
Signature (Head of Department)...........................................................................
Official Institutional Stamp