Alaska Society of Radiologic Technologists

Alaska Society of Radiologic Technologists

Application for Membership
ASRT Member?*

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Membership Fee is $25

Student Membership Fee is free

The membership fee for 5 years is $100 submitted at any time.
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(BA, BS, MA RT(R)(?) Please indicate as desired to appear on membership card, name tags, etc.
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Address*

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Alternate Phone Number*

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Employer*
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Preferred for sharing membership information & AKSRT educational opportunities
Preferred AKSRT contact method for updates and activities*

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Type of Membership*

New Member (Never applied before) 1Continuing member (Renewing membership) 2
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Membership Fee $25.00

Student Membership Fee$ Free

5 Year Membership$100.00

Total $0.00
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