Membership Application | The American Society of Neuroimaging

Current Membership Dues Rates
Physician/Associate: $410
MDs, DOs, PhDs and those with other advanced training

Medical Students/Resident/Trainees: $200
Undergraduate or graduate medical students, residents, or fellows

International: $225
Residing outside of the US and Canada

Advanced Practice Providers: $275
Healthcare professional who is not a physician but has advanced training and licensure

Technologist: $200
Individuals with advanced technical training applied to neuroimaging modalities

Senior: $155
Former active or associate members who have retired from practice or educational pursuits

The membership year runs from November 1st through October 31st. ASN Membership Dues are non-refundable.

Current Membership Promotions

Pay Your Dues Ahead: Receive a 5% discount on the second and third years dues.
Group Membership: Register (3) or more from the same organization and receive a 10% discount. Those eligible for the discount, may not have been an ASN member in the past five years.

AMA Members

As a thank you for being an AMA member and preserving ASN's seat in the AMA House of Delegates you are given $25.00 off your annual dues payment by entering the coupon code AMA1 on the payment page. You must provide your AMA number to qualify for this discount. Please put your number in the question area on page 4 of this application.

Additional Items

In order for your application to be considered for membership, you must upload your current CV in addition to this application. Please click the link on the confirmation page to go to the upload page.

The American Society of Neuroimaging will not use your credit card information for anything other than processing your dues. We do not save any credit card information electronically. Any other information that you provide as a member will not be used without your consent.

Membership Dues

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Contact Information

Email *

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Prefix

First Name *

Middle

Last Name *

Suffix

Title

Informal Name

Affiliation

Address 1 *

Address 2

Address 3

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Include me in Membership Directories *
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Include me in Broadcast Email *
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Please enter the Username/Password you would like to use to login to this website.

Your Username must be unique and must be at least 6 characters.
Passwords must be a minimum of 8 alpha-numeric characters with at least 1 number or 1 letter.

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Payment Details

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Enter the name on the bank account according to the information shown on your bank statement. The account number and routing number can be copied from the lower left corner of the check.

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By submitting payment, I am authorizing The American Society of Neuroimaging to initiate a single or recurring ACH/electronic debit in the amount indicated from the bank account I designated above. I understand that this Authorization will remain in full force and effect until the transaction is cancelled by me by contacting The American Society of Neuroimaging, or the ACH/electronic debit is processed from the designated account. I certify that (1) I am authorized to debit the bank account above and (2) the ACH/electronic payment I am authorizing complies with all applicable laws.

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Enable Automatic Renewals? *

Select "Yes" to enroll in automatic membership renewal. The payment method submitted with this form will be used for your future membership renewals. You can change the automatic renewal setting or saved payment method at any time in either the "Payment Methods" or "Renewal Settings" where you edit your profile.

Yes

SELECTION PROCESS

To ensure full membership benefits please submit applications by November 1. Membership applications are reviewed on an ongoing basis and the membership year runs from November through October. Applications for membership or changes in membership status are presented to the Membership Council for evaluation and recommendation.

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Member Application

Membership Dues

Contact Information

Username/Password Username/Password

Additional Information

Payment Details

Member Application

Membership Dues

Contact Information Contact Information

Username/Password Username/Password

Additional Information Additional Information

Payment Details Payment Details

Contact Information

Additional Information

Payment Details