SOCIETY FOR CARDIOTHORACIC SURGERY

IN GREAT BRITAIN AND IRELAND

APPLICATION FORM FOR ASSOCIATE MEMBERSHIP

Notes

  1. Associate joining fee is currently £30 (non-refundable)
  2. Annual subscriptions are currently £30 preferably paid by direct debit but provision can be made for payments via cheque or credit card. Subscriptions will leave bank accounts on or around 1st January each year with the first payment leaving the January after ratification
  3. Applications can be received throughout the year but can only be ratified at the Annual Business Meeting in March each year
  4. Once an application has been received at the Society offices, it will be processed and correspondence will be provided informing the applicant of the stage at which their application has reached
  5. Membership shall be automatically forfeited if no subscription has been paid for one year after appropriate reminders
  6. Benefits for the Associate Member include:

a.Receive a Bi- Annual Bulletin with contributions from Members of theExecutive and topical issues.

b.Obtain website access with specific access to the members section.

c.Membership to CTSNet and their web publications/educationinformation

d.Ability to shape the development of protocols for shared care

e.Enjoy increased influence in SCTS

f.Ability to network with other organisations

g.Local networks

h.Associate members are eligible to apply for a bursary to support attendance at conferences or to visit other centres

i.Ability to advertise vacancies to allied health professional which includesan

email to the

specific target audience

  1. Database access through SCTS for research and practice development issues
  2. Reduced registration fee to the SCTS Annual Meeting and Cardiothoracic Forum
  3. Members are invited to attend the annual business meeting and to have access to the minutes of Business and Executive meetings produced by the Society via the Website

SOCIETY FOR CARDIOTHORACIC SURGERY

IN GREAT BRITAIN ANDIRELAND

APPLICATION FORM FOR ASSOCIATE MEMBERSHIP

Please complete in BLOCK letters. Applications for Associate members should be proposed by a voting member of the Society and be returned to the address below.

Please attach a cheque with your application form to cover the non-refundable joining fee stated in brackets next to the membership category below. Closing date for 2012 applications – February 17th 2012.

Applications are considered by the Executive Committee and then ratified at the ABM during the Annual Meeting held in March each year.

TitleFirst NameFamily Name

Date of Birth

Position

Hospital

Hospital Address

Post Code Country

Telephone Facsimile

E-mail

Home Address

Post CodeCountry

Please send all correspondence to my: Hospital address Home address

Membership I wish to apply for: Associate(£30 Joining fee non refundable)

Please tick box which most closely reflects your position:

Nurse Surgical Assistant Database Manager Other – please specify

______

Joining fee attached

Signature/Name of Proposing

Member

Signature of Proposing Member Name of Proposing Member (Please Print) Date

Signature of Applicant

Signature of Applicant Date

Society for Cardiothoracic Surgery

35-43 Lincoln’s Inn Fields, London, WC2A 3PE

Tel: +44 20 7869 6893 / Fax: +44 20 7869 6890 / e-mail: