Members Area 
Please download and print out the direct debit and send with your application to the address below.
Criteria For Membership
There are two levels of subscription, please circle yours:
1. "Ordinary" - for members with an interest in the subject, £65 pa plus £30 if you wish your details to be entered on the referral page of the BIMM website.
2. "Higher Rate" - for members earning more than £10,000 pa from Musculoskeletal practice, £150 pa. (Including entry on the web site if desired).
Title...……......................................................................…......
Name and Initials .....………………………………........................
Surname........................…………………………....…......….......
Registerable Qualifications....................................…………......
G.M.C.no ...........................
Practice Address................................................................
................................................................................................
……….................................................................................…..
Post Code ......................................
Telephone No.......................................................................
Fax No.................................................................................
Email...................................................................................
Home Address ......................................................................
.............................................................................................
.............................................................................................
Post Code.............................................................................
Telephone..............................................................................
Email....................................................................................
Type of Practice: NHS GP (single handed / partnership)
....………………………………............................…….............
Hospital (state grade)..........………..........................…….........
Private Practice (GP / Consulting)……………......….…..............
Other .....................................................………………..........
Please give a brief C.V. (indicating type of practice and time spent in each).
Please state your interest and/or experience in Musculoskeletal Medicine. (including how you initially got involved).
Please state how you first heard of BIMM.
Signed.................................................
Dated...........................................