BSSH Affiliate Member Application Form

This application form is for individuals applying for Affiliate Membership of the BSSH. If you are not applying for Affiliate Membership then please return to our website and select the correct membership category here.

If this is your first time applying for Affiliate Membership of the BSSH, please select the create a new user button below and fill in the required details.

If you have used this form before and would like to return to your saved progress, please log in below with the details you set up initially or email secretariat@bssh.ac.uk to be sent your personal link. 

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Affiliate Membership Application Form

BSSH Affiliate Members are practitioners of allied non medical disciplines who have a particular interest in hand surgery, including but not limited to Hand Therapists, Nurse Practitioners, Physicians’ Associates, Artists, Scientists and Statisticians.  

 

Prospective Affiliate members must have the support of one current BSSH member and complete the application process (this includes completing this application form in full, agreeing to join the electronic register of members and agreeing to the Code of Conduct). Applicants may then be accepted as members on payment of the appropriate fee.

Affiliate membership rights

  • Right to attend Annual General Meetings and other General Meetings
  • No voting rights
  • Not eligible to stand for election to the Council or other officer roles of the Society.

 

Applicants will need to upload the following information to be able to complete this form:

  • A copy of your curriculum vitae (maximum length – 2 pages).
  • A direct debit form which must have a wet ink signature on it.  Please download the direct debit form, complete it, sign it and then post it to the BSSH, 38-43 Lincoln's Inn Fields, London WC2A 3PE.  The direct debit form can be downloaded here.
  • The name and email address of a current BSSH Fellow who has agreed to sponsor your application. Please contact secretariat@bssh.ac.uk if you require assistance with this.

For any queries on the application process, please contact the BSSH Secretariat

Please select below to confirm you are applying for Affiliate Membership of the BSSH and continue with your application.

 

 

 

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BSSH Data Processing Policy and Consent

BSSH respects your privacy and is committed to maintaining your personal information in accordance with the requirements of the EU’s General Data Protection Regulation and the Data Protection Act. We will take all reasonable steps to ensure that your personal data is kept secure against unauthorised access, loss, disclosure or destruction. 

Our privacy notice will inform you as to how we collect and look after your personal data. It will also help to explain your privacy rights and how the law protects you. 

Our Privacy Notice applies to the administering of memberships and the general supply products and services offered by BSSH. 

Our full Privacy Policy can be found here: https://www.bssh.ac.uk/privacy_policy.aspx  

Please tick below to confirm you consent to your records being held in this manner and to be released in accordance with this statement.

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Contact Details

Please tell us the best phone number to contact you on

Home Address
Hospital/Institution Address
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Region

Please select the region that best describes where you work

Date of Birth
Sex

 

 

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Qualifications
Special Interest

Please let us know if you have any special interests. Please check all that apply.

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Documents

CV

Please upload a copy of your curriculum vitae (maximum length – 2 pages).

Please ensure to tick the checkbox to confirm you are uploading your curriculum vitae.

Direct debit form

Please upload your completed direct debit form.

If you have yet to download the form, please find it here.

Please select the checkbox to confirm you are uploading your direct debit form. 

 

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Sponsor

Prospective Affiliate members must have the support of one current BSSH Fellow member and complete the full application process. This includes completing this application form in full, signing the electronic register of members and agreeing to the Code of Conduct. They may then be accepted as members on payment of the appropriate fee. 

 

Applicants must provide the full name and email address of the BSSH Fellow member who has agreed to support their application. The BSSH Secretariat reserves the right to check that sponsors have been contacted and are in agreement to support. 

 

 

Sponsor Details
Sponsor Name
Sponsor Email Address
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Summary
Terms and Conditions

By ticking the box below you are acknowledging and agreeing to the following:

  • As a registered charity and company limited by guarantee, the liability of BSSH members is limited. As per our Constitution, in the event of the Society being wound up, all current members, or those within one year of ceasing to be a Member will be liable for payment of any Society debts and/or liabilities to an amount not exceeding £1 per member.
  • On becoming a Member, you will join the register of Members held on the BSSH Membership database.
  • To adhere to the Society’s Code of Conduct
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Thank you for your application.

You should receive a confirmation email within 24 hours of submitting this form.

For further queries, please contact secretariat@bssh.ac.uk. 

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