2024 ACS Membership Registration Form

Name*

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Practice Address:*

Practice Name

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Home Address:

Street Address

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CityState / Province

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Admin Email:

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Are you interested in serving on the Council or a Chapter Committee?

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My Products*

Active Member $135.00

Active members shall be Fellows and Associate Fellows of the American College of Surgeons residing or practicing in the Commonwealth of Virginia who apply for membership in the Chapter and agree to comply with its bylaws.

Affiliate Member$100.00

Affiliate membership is available to physicians and non-physicians who work as part of the operating room team, in the office environment, in research, in surgical education, or in a medical association. Affiliate members will also include those members engaged in the field of surgery, but living outside of Virginia. Affiliate members will apply for membership in the Chapter and agree to comply with its bylaws. Affiliate members may not vote or hold office.

Trainee Member$ Free

Trainee members include Residents and Medical students. Resident members shall be members of the Resident & Associate Society (RAS) of the American College of Surgeons who are currently completing surgical residency or fellowship training in the Commonwealth of Virginia, who apply for membership in the Chapter, and who agree to comply with its bylaws. Medical students shall be currently enrolled in accredited allopathic or osteopathic medical school in Virginia, who apply for membership in the Chapter and agree to comply with its bylaws.

Total $0.00

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Membership Application / Renewal

Fellow dues