The British Society
of Dental and Maxillofacial Radiology

APPLICATION FOR MEMBERSHIP

I wish to become a member of the British Society of Dental and Maxillofacial Radiology. 
If elected, I agree to abide by its Bye-Laws.


Date....................................................Signed...............................................................

Name.............................................................................................................................

Qualifications.................................................................................................................

Address......................................................................................................................... ....................................................................................................................................... ......................................................................................................................................

email address .................................................

Nature of present work
......................................................................................................................................

Note of particular interest/experience related to radiology
.....................................................................................................................................
.....................................................................................................................................
.....................................................................................................................................

Proposed by............................................................If necessary the Secretary 

Seconded by............................................................will arrange this.

The annual subscription to the Society is £30 (ordinary members) and £20 (associate members).

Please do not send money with your application you will be contacted regarding payment after your application has been considered by Council

Please print out and return to:   

Dr Bethan Thomas
Honorary Secretary BSDMFR
Dental Radiological Imaging
Floor 23 Tower Wing
Guy’s Hospital
Great Maze Pond
London SE1 9RT
email: Bethan Thomas