CSRS Senior Membership Request Form

The Cervical Spine Research Society will review requests from any Active Members who request Senior Status at the Winter Board Meeting*. Active members wishing to transition to senior status must confirm that they are either 65 years old or are no longer seeing clinical patients or receiving employment from outside sources. Senior members’ status may also be conferred at the discretion of the Board of Directors on those individuals who request such a change.

Each Senior Member has a right to vote but does not have the right to hold office. Senior Members are not required to pay annual dues or to submit papers for presentation, but shall pay expenses for meetings attended on a pro rata basis.

Changes in membership will be reflected in the 2022 dues cycle beginning January 1, 2022.

*The membership committee may review a select number of applications between January and April of the current dues cycle for late Senior Applications.

Name of Active Member requesting Senior Status *

First Name Last Name

Email Address *

Please confirm the following statement for the 2021 CSRS dues cycle: I am 65 years of age; AND/OR I am no longer seeing clinical patients or receiving employment from outside sources. *

Yes

Upon submitting this form, your request will be sent to the Membership Committee to review. Final decisions on membership changes will be emailed after the December Meeting.