Proposers:This section must be signed by two current (fully paid) members of the BSACI. If two sponsors cannot be found, applicants should send a letter supporting their application. Overseas members who cannot find two BSACI members to endorse their application should send a short CV together with a supporting letter from their head of department. Please note that the final decision rests with the BSACI Council which reserves the right to withhold membership at its discretion.

I, being a member of the British Society for Allergy and Clinical Immunology, do from my personal knowledge recommend this candidate for membership of the Society

Proposer: (Please give full name including title) Seconder: (Please give full name including title)

Name: Name:

Address: Address:

Signature: Signature:

Date: Date:

When completed, please send this application form (together with your cheque if applicable) to:BSACI Secretariat, Studio 16, Cloisters House, 8 Battersea Park Road, London SW8 4BG

Payment:

Please note UK members who choose not to pay by Direct Debit will automatically incur a £15 administration fee.

o I enclose a cheque made payable to BSACI for £

o Credit card payment (Overseas membership applicants only)

o Mastercard o Maestro o Visa o Delta o Visa Electron o Switch o Solo o American Express

Card number: o o o o o o o o o o o o o o o o

Security no: o o o o Valid from: o o /o o Expires: o o /o o Amount £ Signature: Date:

o Direct Debit

Instruction to your Bank or Building Society to pay by Direct DebitPlease pay BSACI Direct Debits from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with BSACI and, if so, details will be passed electronically to my Bank/Building Society.

Name and full postal address of your Bank or Building Society

Banks and Building Societies may not accept Direct Debit instructions for some types of account

Name(s) of account holder(s)

Branch Sort Code: o o o o o oBank/Building Society account number: o o o o o o o oSignature Date

Originator’s Identification Number: 9 1 5 3 9 9

BSACI Reference (official use only):

The Direct Debit Guarantee

• This Guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme. The efficiency and security of the Scheme is monitored and protected by your own Bank or Building Society.

• If the amounts to be paid or the payment dates change The BSACI will notify you 10 working days in advance of your account being debited or as otherwise agreed.

• If an error is made by The BSACI or your Bank or Building Society you are guaranteed a full and immediate refund from your branch of the amount paid.

• You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Please also send a copy of your letter to us.

To: The Manager

AddressD

etach form and return to B

SACI

The BSACI continues to be a major focus for clinicians and scientists in the UK and overseas. Our aim is to support the needs of those who provide high quality NHS based allergy services for those with allergic disease and related disorders of the immune system.

BSACI membership is open to all registered medical practitioners and those engaged in research teaching or clinical practice, relevant to allergy and clinical immunology.

BSACI is the national, professional and academic society representing the specialty of allergy at all levels. Its main objective is to improve allergy care – through education, training and research. It achieves this by:

• Informing opinion leaders by campaigning to improve allergy services.

• Encouraging research into allergic diseases and disorders of the immune system.

• Providing allergy education for both primary and secondary care clinicians, scientists and allied health professionals.

• Promoting allergy education for undergraduate medical students.

• Representing the specialty at the Royal College of Physicians (RCP), Royal College of Paediatric and Child Health (RCPCH), Joint Committee of Immunology and Allergy (JCIA) and within the National Allergy Strategy Group (NASG).

• Working with other societies, training and patient organisations, to educate and raise awareness of allergy nationally.

• Providing educational opportunities and to build closer links with other disciplines including ENT surgeons, respiratory physicians, dermatologists and gastroenterologists where allergy may be a subspecialty interest.

• Maintaining international collaboration, for example with the World Allergy Organisation (WAO), the European Academy of Allergy and Clinical Immunology (EAACI) and the American Academy of Asthma, Allergy and Immunology (AAAAI).

British Society for Allergy & Clinical Immunology

Membership Application Form

Des

igne

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id o

ut a

nd p

rint

ed b

y IN

Q D

esig

n. C

all M

ike

on 0

20 7

737

5775

The British Society for Allergy and Clinical Immunology is a company limited by guarantee (No. 3505635)and a registered charity (No. 1069199)

All members receive reduced registration rates and advance notification of Society meetings, the newsletter Allergy Update, and access to the ‘Members Only’ section of the website for publications, guidelines, up-to-date news and the Members Forum. Overseas, Full UK and Junior Associate Members receive the Society’s monthly journal Clinical and Experimental Allergy.

If you would like to apply to become a member of the Society, please complete the application form and return it together with the relevant subscription fee to:

BSACI Secretariat, Studio 16, Cloisters House, 8 Battersea Park Road, London SW8 4BG Tel: +44 (0) 207 501 3910 Fax: +44 (0) 207 627 2599

*NB: Please refer to our website for current subscription fees.

NB BSACI subscriptions are renewable annually and the Rules of the Society state that members will be removed if they do not pay their subscription one month after receiving the second reminder letter. Members who pay after a month of receiving the second reminder will incur a £10 late payment fee. Alternatively members may avoid this fee by setting up a direct debit. Anyone who doesn’t pay the late fee or has not set up a direct debit will be removed from the membership.

Membership categories and rates

Membership category Rate per annum Benefits

• Overseas member See website* Members receive the monthly journal Clinical and Experimental Allergy, the BSACI newsletter Allergy Update and a discount to the BSACI Annual Meeting.

• Full UK member See website* Members receive the monthly journal Clinical and Experimental Allergy, the BSACI newsletter Allergy Update and a discount to the BSACI Annual Meeting.

• Associate member See website* Members receive a discount to the BSACI Annual Meeting and the BSACI newsletter Allergy Update.

• Junior Associate member See website* To qualify members must be under 35 years old or any non-clinician within five years of their last higher degree (eg PhD, MSc) or any clinical trainee in allergy or clinical immunology or a related clinical specialty. They receive a higher discount to the BSACI Annual Meeting, the monthly journal Clinical and Experimental Allergy and the BSACI newsletter Allergy Update. Junior members are also given preference when applying for BSACI Travel Fellowships.

• Allied Health Professional See website* Members receive the BSACI newsletter Allergy Update, a higher discount to the BSACI Annual Meeting and preference when applying for Fellowships.

• Student member See website* Members receive the BSACI newsletter Allergy Update and a higher discount to the BSACI Annual Meeting. Student members are also eligible to apply for Travel Grants.

Application formI, being engaged in the practice of allergy and/or clinical immunology or in research or teaching in these fields, wish to become a member of the British Society for Allergy and Clinical Immunology and, if elected, agree to observe the rules stated in the Society's constitution and promote the honour and interest of the Society.

Signature Date

Your details:

o Professor o Dr o Mr o Mrs o Miss o Ms o Other

Surname: Forenames:

Date of birth: (if under 35 years) / / Qualifications:

Present appointment:

What is your primary specialism?

Additional specialism (if any):

Work address: (please include department if applicable) Home address:

Postcode: Postcode:

Work tel no: Fax no: Home tel no:

Please indicate which address should be used for correspondence o Work o Home

Email address: (please print clearly)

o Members Directory - By ticking this box you have agreed to have your name, hospital and work email address published on the members section of the BSACI website

As a BSACI member you are entitled to receive the World Allergy Organisation Newsletter. Do you agree to your email address being passed on to WAO for this purpose? o Yes o No

Please state how you heard about the BSACI

Membership required:

o Full Overseas Membership* o Full UK Membership* o Associate Membership*

o Junior Associate Membership* o Allied Health Professional Membership* o Student*

Briefly state your experience in allergy and/or clinical immunology:

Publications: (please list no more than 5 relevant publications)

1.

2.

3.

4.

5.

(please give direct/departmental numbers)

(If no address is indicated, the work address will be used)

Please complete both sides of this form

Det

ach

form

and

ret

urn

to B

SAC

I

DANONEBABY NUTRITION

The printing of this form is supported by

All members receive reduced registration rates and advance notification of Society meetings, the newsletter Allergy Update, and access to the ‘Members Only’ section of the website for publications, guidelines, up-to-date news and the Members Forum. Overseas, Full UK and Junior Associate Members receive the Society’s monthly journal Clinical and Experimental Allergy.

If you would like to apply to become a member of the Society, please complete the application form and return it together with the relevant subscription fee to:

BSACI Secretariat, Studio 16, Cloisters House, 8 Battersea Park Road, London SW8 4BG Tel: +44 (0) 207 501 3910 Fax: +44 (0) 207 627 2599

*NB: Please refer to our website for current subscription fees.

NB BSACI subscriptions are renewable annually and the Rules of the Society state that members will be removed if they do not pay their subscription one month after receiving the second reminder letter. Members who pay after a month of receiving the second reminder will incur a £10 late payment fee. Alternatively members may avoid this fee by setting up a direct debit. Anyone who doesn’t pay the late fee or has not set up a direct debit will be removed from the membership.

Membership categories and rates

Membership category Rate per annum Benefits

• Overseas member See website* Members receive the monthly journal Clinical and Experimental Allergy, the BSACI newsletter Allergy Update and a discount to the BSACI Annual Meeting.

• Full UK member See website* Members receive the monthly journal Clinical and Experimental Allergy, the BSACI newsletter Allergy Update and a discount to the BSACI Annual Meeting.

• Associate member See website* Members receive a discount to the BSACI Annual Meeting and the BSACI newsletter Allergy Update.

• Junior Associate member See website* To qualify members must be under 35 years old or any non-clinician within five years of their last higher degree (eg PhD, MSc) or any clinical trainee in allergy or clinical immunology or a related clinical specialty. They receive a higher discount to the BSACI Annual Meeting, the monthly journal Clinical and Experimental Allergy and the BSACI newsletter Allergy Update. Junior members are also given preference when applying for BSACI Travel Fellowships.

• Allied Health Professional See website* Members receive the BSACI newsletter Allergy Update, a higher discount to the BSACI Annual Meeting and preference when applying for Fellowships.

• Student member See website* Members receive the BSACI newsletter Allergy Update and a higher discount to the BSACI Annual Meeting. Student members are also eligible to apply for Travel Grants.

Application formI, being engaged in the practice of allergy and/or clinical immunology or in research or teaching in these fields, wish to become a member of the British Society for Allergy and Clinical Immunology and, if elected, agree to observe the rules stated in the Society's constitution and promote the honour and interest of the Society.

Signature Date

Your details:

o Professor o Dr o Mr o Mrs o Miss o Ms o Other

Surname: Forenames:

Date of birth: (if under 35 years) / / Qualifications:

Present appointment:

What is your primary specialism?

Additional specialism (if any):

Work address: (please include department if applicable) Home address:

Postcode: Postcode:

Work tel no: Fax no: Home tel no:

Please indicate which address should be used for correspondence o Work o Home

Email address: (please print clearly)

o Members Directory - By ticking this box you have agreed to have your name, hospital and work email address published on the members section of the BSACI website

As a BSACI member you are entitled to receive the World Allergy Organisation Newsletter. Do you agree to your email address being passed on to WAO for this purpose? o Yes o No

Please state how you heard about the BSACI

Membership required:

o Full Overseas Membership* o Full UK Membership* o Associate Membership*

o Junior Associate Membership* o Allied Health Professional Membership* o Student*

Briefly state your experience in allergy and/or clinical immunology:

Publications: (please list no more than 5 relevant publications)

1.

2.

3.

4.

5.

(please give direct/departmental numbers)

(If no address is indicated, the work address will be used)

Please complete both sides of this form

Det

ach

form

and

ret

urn

to B

SAC

I

DANONEBABY NUTRITION

The printing of this form is supported by

Proposers:This section must be signed by two current (fully paid) members of the BSACI. If two sponsors cannot be found, applicants should send a letter supporting their application. Overseas members who cannot find two BSACI members to endorse their application should send a short CV together with a supporting letter from their head of department. Please note that the final decision rests with the BSACI Council which reserves the right to withhold membership at its discretion.

I, being a member of the British Society for Allergy and Clinical Immunology, do from my personal knowledge recommend this candidate for membership of the Society

Proposer: (Please give full name including title) Seconder: (Please give full name including title)

Name: Name:

Address: Address:

Signature: Signature:

Date: Date:

When completed, please send this application form (together with your cheque if applicable) to:BSACI Secretariat, Studio 16, Cloisters House, 8 Battersea Park Road, London SW8 4BG

Payment:

Please note UK members who choose not to pay by Direct Debit will automatically incur a £15 administration fee.

o I enclose a cheque made payable to BSACI for £

o Credit card payment (Overseas membership applicants only)

o Mastercard o Maestro o Visa o Delta o Visa Electron o Switch o Solo o American Express

Card number: o o o o o o o o o o o o o o o o

Security no: o o o o Valid from: o o /o o Expires: o o /o o Amount £ Signature: Date:

o Direct Debit

Instruction to your Bank or Building Society to pay by Direct DebitPlease pay BSACI Direct Debits from the account detailed in this Instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with BSACI and, if so, details will be passed electronically to my Bank/Building Society.

Name and full postal address of your Bank or Building Society

Banks and Building Societies may not accept Direct Debit instructions for some types of account

Name(s) of account holder(s)

Branch Sort Code: o o o o o oBank/Building Society account number: o o o o o o o oSignature Date

Originator’s Identification Number: 9 1 5 3 9 9

BSACI Reference (official use only):

The Direct Debit Guarantee

• This Guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme. The efficiency and security of the Scheme is monitored and protected by your own Bank or Building Society.

• If the amounts to be paid or the payment dates change The BSACI will notify you 10 working days in advance of your account being debited or as otherwise agreed.

• If an error is made by The BSACI or your Bank or Building Society you are guaranteed a full and immediate refund from your branch of the amount paid.

• You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Please also send a copy of your letter to us.

To: The Manager

Address

Detach form

and return to BSAC

I

The BSACI continues to be a major focus for clinicians and scientists in the UK and overseas. Our aim is to support the needs of those who provide high quality NHS based allergy services for those with allergic disease and related disorders of the immune system.

BSACI membership is open to all registered medical practitioners and those engaged in research teaching or clinical practice, relevant to allergy and clinical immunology.

BSACI is the national, professional and academic society representing the specialty of allergy at all levels. Its main objective is to improve allergy care – through education, training and research. It achieves this by:

• Informing opinion leaders by campaigning to improve allergy services.

• Encouraging research into allergic diseases and disorders of the immune system.

• Providing allergy education for both primary and secondary care clinicians, scientists and allied health professionals.

• Promoting allergy education for undergraduate medical students.

• Representing the specialty at the Royal College of Physicians (RCP), Royal College of Paediatric and Child Health (RCPCH), Joint Committee of Immunology and Allergy (JCIA) and within the National Allergy Strategy Group (NASG).

• Working with other societies, training and patient organisations, to educate and raise awareness of allergy nationally.

• Providing educational opportunities and to build closer links with other disciplines including ENT surgeons, respiratory physicians, dermatologists and gastroenterologists where allergy may be a subspecialty interest.

• Maintaining international collaboration, for example with the World Allergy Organisation (WAO), the European Academy of Allergy and Clinical Immunology (EAACI) and the American Academy of Asthma, Allergy and Immunology (AAAAI).

British Society for Allergy & Clinical Immunology

Membership Application Form

Des

igne

d, la

id o

ut a

nd p

rint

ed b

y IN

Q D

esig

n. C

all M

ike

on 0

20 7

737

5775

The British Society for Allergy and Clinical Immunology is a company limited by guarantee (No. 3505635)and a registered charity (No. 1069199)