Membership Checkout – Australian Hand Surgery Society

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Membership Level change

You have selected the Active membership level.

The price for membership is $800.00 now and then $700.00 per Year.

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Username

Password

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Email Address

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Full Name LEAVE THIS BLANK

More Information

First Name

Last Name

Phone Number

Country

Street

Suburb

State/Province

Postcode

Practice name

Practice Street

Practice Suburb

Practice State

Practice Postcode

Birth Date

Place of Birth

Spouse’s name

Proposer name

Seconder name

C.V. File (Please select a copy of your most recent C.V)

Photograph (Include a recent photograph of yourself)

Letter (Include a letter from your proposer)

Letter (Include a letter from your seconder)

Degrees and Diplomas (with dates and locations)

Present Surgical Appointments

Publications Relevant to Hand Surgery

Areas of interest

Show my details in the Public Hand Surgeons Directory on this site

Yes

Your practise contact details will be shown in the public directory on the site. This is for Active, Senior, Provisional and Corresponding Members.

Show my details in the Public Hand Surgeons Directory on this site

Yes

Your practise contact details will be shown in the public directory on the site. This is for Active, Senior, Provisional and Corresponding Members.

Show my details in the Private Members Directory on this site

Yes

Your practise contact details will be shown in the private members-only directory on the site. This is for all Members.

Billing Address

First Name

Last Name

Address 1

Address 2

City

State

Postal Code

Country

Phone

Payment Information We Accept Visa, Mastercard, American Express, and Discover

Card Number

Expiration Date /

Security Code (CVC)