The Aesthetic Foundation Membership Form

The Aesthetic Foundation Membership Form

Please complete this form, and a member of our team will contact you for payment information to complete the $350 Aesthetic Foundation dues payment. We thank you for your support of The Aesthetic Foundation!
I am an Active or Associate Member of The Aesthetic Society and/or ASPS*

YesNo. Please see the next question.
If you are not a Member of The Aesthetic Society and/or ASPS, please indicate which applies to you below (required by The Aesthetic Foundation Bylaws to be considered for membership).

Certified or Board-eligible by The American Board of Plastic Surgery (ABPS)Certified in plastic surgery by the Royal College of Physicians and Surgeons of CanadaInternational (outside of U.S. and Canada) plastic surgeon who is an active member of their country’s national plastic surgery society acceptable to the Board of The Aesthetic FoundationInternational (outside of U.S. and Canada) plastic surgeon who is an active member the International Society of Aesthetic Plastic Surgeons (ISAPS)None of the above apply

Your full name (example: Jane B. Smith, MD)*
Preferred phone number to contact you for payment:*
Is there someone in your office other than you we should ask for? If so, please provide their full name here:
If there are preferred days/timeframes that you would like us to call, please let us know here. Include your time zone (example: Tuesdays between 2-5pm Pacific):
You have completed the Form, you may now click "Submit".
The Aesthetic Surgery Education and Research Foundation (The Aesthetic Foundation) is a 501(c)(3) charitable organization, Tax ID #33-0613185. Your donation is tax-deductible to the full extent of the law. No goods or services will be received in return for your donation. Please note that the initial $350 of your payment is considered dues and is deductible as a business expense while any additional amount is considered a fully tax-deductible donation.

Thank you for you interest in becoming a member of The Aesthetic Foundation. Unfortunately, you do not meet the requirements to be a member at this time. If you would like to make a donation to The Foundation, your support would be put to good use for the program or service that you feel most appropriately meets your giving needs. The donation page can be accessed here: https://www.theaestheticfoundation.org/donate/donate-now.

Thank you from The Aesthetic Foundation!
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