CSRS Membership Application

CSRS Membership Application

All materials must be complete before submitting application. Deadline for submission is September 15, 2026.
Name*

First NameLast NameDesignation
Email*
example@example.com
Institution*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Which address is your preferred address?*

HomeBusiness
Business Phone*
Please enter a valid phone number.
Mobile*
Please enter a valid phone number.
For what membership class are you applying?*
I am a resident or fellow.I am currently practicing.
Are you Board Certified?*
Are you Board eligible?*

YesNo
What type of Board certification?
I attest that I am within seven (7) years of expected completion of a training program and am Board eligible and in the process of Board certification.*

YesNo
You are not eligible to apply as a Candidate member. Please look into Active membership requirements and consider applying in the future.
Year for Board Exam 1*
Board Certification Exam Year *
Year for Board Exam 2*
Upload Curriculum Vitae*

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Upload Personal Statement*

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Are you currently a Candidate member?*

YesNo
If applying for Active membership and you are currently a Candidate member, the sponsor letter cannot be from the same Active Member who submitted for your Candidate membership.
Upload CSRS Active Sponsor Letter 1 *

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List the name of the Active member sponsor
Upload Active CSRS Sponsor Letter 2 *

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List the name of the Active member sponsor
Upload Active CSRS Sponsor Letter 3 *

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List the name of the Active member sponsor
Have you attended a CSRS Annual Meeting?*

YesNo
I attest that I will pay for and register for the CSRS Annual Meeting this year.*

I will.
List the year of the latest CSRS Annual Meeting you attended.*
Have you authored or co-authored a paper or poster submitted at a CSRS Annual Meeting prior to consideration of your application?*

YesNo
In the last four years, have you authored or co-authored a paper or poster submitted at a CSRS Annual Meeting?*

YesNo
Was your paper presented at the CSRS Annual Meeting?*

YesNo
What was the title of the accepted paper and the year it was submitted?*
If your paper was not presented at a CSRS Annual Meeting, please provide other work citations from peer-reviewed cervical spine journals.*

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If not Board eligible, you must have been in practice a minimum of three years with a practice focused on spine surgery. Submit a letter from Chief of your department or division stating your practice is primarily spine based, and you are in good standing based on your departmental guidelines.*

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Please provide at least one publication related to the cervical spine as the first author or a co-author in an international journal written in English and indexed in PubMed. Citation or copy of submission accepted.*

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I attest that I am in good standing with the state/international medical board.*

AgreeDisagree
I hereby certify that the information provided in this application form is accurate to the best of my knowledge and belief. I acknowledge and agree that completion of this application grants the Cervical Spine Research Society my permission to take any necessary steps to verify my credentials and qualifications, including, but not limited to, contacting any organization, licensing board, or institution listed above or listed in the enclosed CV.*
"Sign" to agree to the above statements.
You are welcome to save your application and return to it if the application is not complete. All materials must be complete before submitting.

The deadline for Membership application submissions is September 15, 2025 11:59 CST.
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