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This form is to apply for membership of BASK. Applicants must be practicing orthopaedic surgeons with an interest in knee surgery, confirmed by provision of a CV. The application must be supported by two referees who are currently members of BASK and you will need to gain their consent to provide their GMC numbers as part of this application.

E-mail*

Password*

Confirm Password*

Please provide the GMC number of two current BASK members who are willing to support your application to join BASK. By entering their numbers you are confirming that you have already discussed your application with them.

Bask Member Referee 1 (GMC ID)*

Bask Member Referee 2 (GMC ID)*

Please upload a current 2 page CV*

Upload

Title*

Given Names*

Initials*

Surname*

Home address*

Address 2

Address 3

City*

County*

Postcode*

Country*

Home telephone

Work telephone

Mobile telephone

I don't have a GMC ID number

Yes

My GMC Number

Grade*

Main employer / hospital

BOA Number

BOSTA Member?

Yes

Please tick your subspecialty area(s) of interest:

Special interest (arthroplasty)

Yes

Special interest (soft tissue)

Yes

Special interest (patellofemoral)

Yes

Special interest (Cartilage)

Yes

I am happy to participate in BASK supported surveys

Yes

Only fill in if you are not human