THE BRITISH ASSOCIATION OF ENDOCRINE AND THYROID
SURGEONS
at the Royal College of Surgeons
35/43 Lincoln’s Inn Fields
London WC2A 3PE
Tel:020 7304 4771 Membership: 020 7304 4778 Fax: 020 7430 9235
PRESIDENT: Mr John Watkinson HON SECRETARY: Mr Ashu Gandhi
PROPOSAL FORM
PLEASE COMPLETE IN BLOCK CAPITALS
Name in Full ________________________________________________________________
Title_______________________________________ Date of Birth _____________________
*Home Address ______________________________________________________________
Telephone No._____________ Fax No._________________ Email ____________________
Qualifications and Dates _______________________________________________________
Present Appointment, and year of starting _________________________________________
* Hospital Address ___________________________________________________________
___________________________________________________________________________
Telephone No.______________ Fax No._________________ Email ___________________
NHS Region of Employment (if applicable) ________________________________________
*Please indicate address preferred for Correspondence
Membership of the BAETS is open to consultants with an interest in endocrine disease whose
application is supported by two active members of the Association; higher surgical trainees
who have presented two papers at an annual meeting may also be considered.
Type of membership. Please indicate:




Full Member - Consultant Surgeons, Physicians, Pathologists, Medical Physicists or
Biochemists
Corresponding Member - living and working abroad
Affiliate Member - Higher Surgical Trainees, Non-Consultant Career Grade medical staff,
Nurse Specialists
Senior Member - retired from NHS
We, the undersigned, testify that _________________________________________________
who is personally known to us, is in every way a suitable candidate for election to the
BAETS.
Signed(1)___________________________Name in Capitals__________________________
(2)___________________________Name in Capitals__________________________
Full members of the British Association of Endocrine Surgeons
Date Received______________________________Approved_________________________
Completed proposal forms to be returned to Mrs Bhavnita Borkhatria Patel, Administrator,
British Association of Endocrine and Thyroid Surgeons, The Royal College of Surgeons of
England, 35-43 Lincoln’s Inn Fields, London, WC2A 3PE.
Subscription Rates for 2013:
Full Member
Affiliates Member
£60.00
£30.00
Corresponding and Senior Members No Fee
Please do NOT send payment with initial application forms, as payment will be collected
following confirmation of membership