ASTRO Application for Transfer to Emeritus Membership

ASTRO Emeritus Membership Eligibility Requirements

Emeritus membership may be conferred by the Board of Directors of the Society upon request to the Secretary/Treasurer for any Active, Associate, Affiliate or International member who has been a member for at least five of the prior seven years and who has voluntarily retired from active practice or who has been retired for at least one year by reason of physical disability. Individuals requesting a transfer to Emeritus membership must be fully retired. You are not eligible for Emeritus membership if you are currently working Locum Tenens or if you are working in health care on a full-time, part-time or consulting basis.

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Your Information:

*Indicates required field

Member ID

ASTRO Join Date

Member Type

Member Name

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Previous Business Address

Company

Street Address

City

State

Zip Code

Country

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Home Address

*Indicates required field.

Street Address

City

State/Province

Zip Code/Postal Code

Country

Phone Number

Cell Number

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Which address would you like us to set as your preferred mailing address?

*Please select one.

PreferredAddressButtons Business Address Home Address

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Which is your preferred email address?

*Please select one.

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Reason for request for transfer to ASTRO Emeritus membership:

*Please select one.

Request Reason Voluntary Retirement Permanent Illness/Disability

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Date of Retirement

Today's Date

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The ASTRO Membership Committee will review requests for Emeritus membership and will report decisions to the ASTRO Board of Directors. The Membership Committee may request additional information to assist in making a determination. You will be notified of the decision no more than 45 days after receipt of request. Emeritus membership will begin immediately following approval. Membership dues for the current year is not refundable.

By clicking submit, you acknowledge that you have read and understand the eligibility requirements for ASTRO Emeritus membership and the information provided is accurate.

Membership

ASTRO Application for Transfer to Emeritus Membership

ASTRO Emeritus Membership Eligibility Requirements

Your Information:

Previous Business Address

Home Address

Which address would you like us to set as your preferred mailing address?

Which is your preferred email address?

Reason for request for transfer to ASTRO Emeritus membership:

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