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Home > Surgical Resident Membership Application

2008-2009 SURGICAL RESIDENT MEMBERSHIP APPLICATION

RESIDENT PAYMENT INFORMATION
ACFAS Resident Membership year is October 1 thru September 30

Membership Dues:$112October thru September
$56April thru September

Credit card will be charged after approval of application.

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First Name:*
Middle Inital:
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Residency Program Hospital/Clinic
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