Get Membership Application - Surgical Assistant - Surgicalassistant

Filling out the Membership Application for the Surgical Assistant is a straightforward process that can be completed online. This guide will walk you through each section of the form, ensuring that you provide all necessary information accurately.

Follow the steps to complete your application with ease.

1. Click the ‘Get Form’ button to access the Membership Application - Surgical Assistant.
2. Begin by entering your last name, first name, and middle initial in the designated fields. Ensure that all names are spelled correctly.
3. Provide your complete address, including apartment number (if applicable), city, state, and zip code. This information is crucial for communication purposes.
4. Next, input your home and work phone numbers in the respective fields. This allows ASA to contact you if further information is needed.
5. Indicate whether you have previously been a member of ASA by selecting 'Yes' or 'No.' If 'Yes,' please provide the name you were registered under.
6. Input your email address to receive membership information and updates. Ensure that this is an active email account.
7. Specify how you were recruited to ASA by providing the name of the member who referred you, if applicable.
8. Review the membership categories and their related fees. Choose the appropriate option for your membership dues or exam bundle by checking the corresponding box.
9. If applicable, enter your certification details including the credential held, certification number, and certification start/end dates for verification purposes.
10. Students must complete the section for educational information, including the name of the school, start date, instructor’s name, graduation date, and instructor’s email address.
11. Select your payment method. If paying via credit card, enter your card details, including the card number and expiration date, and provide your signature.
12. Before final submission, review all entered information for accuracy. Once confirmed, you have the option to save changes, download, print, or submit the form directly to ASA.

Complete your Membership Application online today to join the ASA community!