Annual Dues | Philadelphia Academy of Surgery

Dues and Fees

A. Annual Dues - $ 200.00: A. Annual Dues $200. I am a fellow member of the Philadelphia Academy of Surgery. Enclosed is my annual dues.

B. Nonresident Fellow - $ 150.00: I live more than 100 miles from Philadelphia.

C. Retired Fellow - $ 60.00: I am no longer in the active practice of surgery.

Payment for Meals

$85.00
I am including payment for meals at $85.00 each - Practicing Physician. Please indicate the number of meals you are paying for in the above field.

Payment for Meals - Resident Guest

$75.00
I am including payment for meals at $75.00 each - Resident Guest. Please indicate the number of meals you are paying for in the above field.

Total Amount

Annual Dues

First Name *

Last Name *

Company / Organization *

Title / Position *

Street Address *

Address 2

Address 3

City

State *

Zip / Postal Code *

Country *

Phone *

Mobile Phone Number *

Fax

Email Address *

Search

CiviContribute