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Application Form for Membership of FOrTE

Membership of FOrTE is currently FREE

Title:
Given Name:
Family Name:
Qualifications:
House name or number:
Street:
Town:
City:
Postcode:
Email Address:
Country of origin:
Country where working now:
Telephone Number(include International code):
Date of Birth:	/ /
Year of Qualification
Year of starting Orthopaedic Specialist Training
Sub-specialty interest
Do you have a National Trainees Organisation? If possible, please provide contact details
Do you wish to be included in the FOrTE email forum?	Yes No
I wish to subscribe to the printed Combined Volume of the JBJS at the 50% discount £80.10.	Yes please.
I wish to subscribe to the Combined Volume of the JBJS on disc at the discounted price: £103.20.	Choose either one DVD or two CDs .
I wish to subscribe to the printed British Volume of the JBJS at the 50% discount: £39.50.	Yes please.
I wish to subscribe to the printed American Volume of the JBJS at the 50% discount: £52.75.	Yes please.
My credit card details are as follows: Visa , MasterCard , American Express . My credit card number is /// the expiry date is and the security numbers are ()^*
Signature:
Your subscription will be delivered to the address given above. If the billing address for the credit card is different from the delivery address please give the billing address here.
Please confirm that you are happy to receive emails from the FOrTE executive committee and The Journal of Bone and Joint Surgery and for your details to be held on their respective databases.	Yes No
If you are subscribing to the JBJS, please print the form, sign it and fax it to: +44 (0)20 7782 0995

^* You will find the security numbers in the top right-hand corner of the signature strip on the reverse of your credit card.

(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299 Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General