American Society of Dermatology



 American Society of Dermatology, Inc.
A Voice for Private Dermatologists Since 1992

Application for Membership

      First   M   Last 
     Degree 
Corporation 
    Address 
       City   ST  ZIP 
      Phone   Fax


MEMBERSHIP CATEGORY
Please curse down to review membership classification categories.

FELLOW -
(80% of more of my time is in private dermatologic pratice.)
Annual Dues: $275

ASSOCIATE -
(less than 80% of my time is in private dermatologic practice.)
Annual Dues: $275

AFFILIATE -
(I subscribe to the ASD Mission Statement and I wish to support its activities.)
Annual Dues: $275

CORPORATE -
(Approved Organizations.)
Annual Dues: $275
STUDENT -
(Full time Medical Student.)
Month & Year expect to graduate and begin Residency -
Annual Dues: $12

RESIDENT -
Month & Year expect to enter practice -
Annual Dues: $31

PAYMENT
My check in the amount of $275 for membership in the American Society of Dermatology will be sent by mail.

Please make your check payable to:

American Society of Dermatology
2721 Capital Ave.
Sacramento, CA 95816-8335
Phone (916) 446-5054
Fax (916) 446-0500

MEMBERSHIP CLASSIFICATION CATERGORIES


  • Fellows
    A physician who is a resident of the United States, is certified or eligible to be certified by the American Board of Dermatology or subcertified or eligible to be subcertified in Dermatopathology and who spends at least eighty percent (80%) of his or her professional time in direct patient care shall be eligible to be a Fellow. A provider of direct patient care is a physician who provides one-on-one, face-to-face patient care, as distinguished from a physician who supervises others who then administer direct patient care. Fellows shall have full membership rights as recognized under customary parliamentary practice, including, but not limited to, the right to attend and participate in all meetings, to vote, to hold office if elected, and to be a member or chairperson of a committee of the Society. Fellows shall be obligated to pay all dues and assessments imposed on Fellows by the Society and shall be obligated to observe all bylaws and administrative regulations of the Society.

  • Associates
    A physician who is a resident of the United States and is certified or eligible to be certified by the American Board of Dermatology shall be eligible to an Associate of the Society. Associates shall have all of the membership rights of Fellows, except that Associates shall not be eligible to vote, to hold elected office in the Society, or to chair committees of the Society. Associates shall be obligated to pay all dues and assessments imposed on Associates by the Society and shall be obligated to observe all bylaws and administrative regulations of the Society.

  • Affiliates
    An individual who subscribes to the Mission Statement of the Society and wishes to participate in and support its activities shall be eligible to be an Affiliate. Affiliate members shall not have the right to vote or hold office. Affiliates shall be obligated to pay all dues and assessments imposed on Affiliates by the Society and shall be obligated to observe all bylaws and administrative regulations of the Society.

  • Resident Members
    A physician enrolled in a dermatology residency training program in the United States which is approved by the Accreditation Council for Graduate Medical Education is eligible to be a Resident Member of the Society. Residents shall have the same membership rights as Associates. Resident membership shall cease automatically in the event that an individual no longer satisfies the eligibility criteria set forth above, except that a Resident Member who has become eligible for membership as a Fellow or an Associate and who has promptly submitted a complete application and any assessments necessary for application for membership as a Fellow or an Associate may continue to be a Resident Member for six (6) additional months from the date the individuals Resident membership would otherwise have automatically ceased.

  • Corporate Members
    Organizations approved by the Board of Directors which wish to support the activities of the Society or contribute to the support of its programs, shall be eligible to be Corporate Members. Corporate Members shall not have the right to vote or hold office. Corporate Members shall be obligated to pay all dues and assessments imposed on Corporate Members by the Society and shall be obligated to observe all bylaws and administrative regulations of the Society.
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