FQMS

To submit your application please either complete the form below, or download the attached form, print and sign and send with your cheque to the address below.

Membership donation is £36.00 a year per person. Any donation above this amount is gratefully received.

Please select one of the following options:

I/We wish to renew our membership of FQMS

I/We support FQMS's object and wish to apply for membership

Using Gift Aid means that for every pound you give, we get an extra 28 pence from the Inland Revenue, helping your donation go further. This means that £10 can be turned into £12.80 just so long as donations are made through Gift Aid. Imagine what a difference that could make, and it doesn't cost you a thing.

So if you want your donation to go further, Gift Aid it. Just select the Gift Aid Declaration box below.

Gift Aid Declaration: I/We wish all donations made since 6 April 2000 and all donations we make from the date of this declaration until you are notified otherwise to be treated as Gift Aid donations.

To qualify for Gift Aid, what you pay in income tax or capital gains tax must at least equal the amount we will claim in the tax year.

Name/s

Address

Postcode

Email

Telephone

Signature

_____________________________________

Date

Cheque/postal order £ __________________ enclosed

When filled and signed, please post this form to:

David Wolton

34 Estelle Road

London

NW3 2JY

The Foundation for Al-Quds Universotu Medical SchololRegistered Charity No 1063835, a company limited by guarantee No 3398543 England,

Advisory Council: Professor Colin Green FRCS (president) Mustafa Beidas Sawsan Asfari* Dr Mahmud Bustami* Dr Pauline Cutting OBE FRCS Professor Simon Frostick FRCS Dr Saleem Haj Yahia Dr Abdel Raouf Garoushe* Liz Green Dr Fuad Haddad* Professor Georges Hennen Dr Rafiq Husseini* Zina Jardaneh* Dr Ahmed Massoud* Chris McConville* (treasurer) Dr Lina Nashef* Said Shehadeh* David Wolton* (chairman) Mr Farouk Younis FRCS*

registered office 75 & 76 Shoe Lane London EC4 A 3JB David Freeman (secretary) *trustees