Dues Notice - 2009

NOTE: Fill in the your information first, then print a hard copy to fax.

Name:

Mailing Address:


Phone:

Fax:

E-mail:

*** I would Like to receive my newsletter by:

E-mail           Regular mail

Membership Classification:
A)
Active Member   $45.00

Registered by a national examination in one of the following disciplines. Please specify.

 

  R.E.T.
R.EP.T.

 R.EEG.T
R.PSG.T.

R.T.(EMG)
         Other

B)
Associate Member   $45.00

Registration not completed / retired

C)
Student Member   $10.00

Currently in training


Please make cheque payable to B.C.S.E.T. and return this completed form to the address below.

Rhonda Lee
EDS Neurology Department, South 1
Royal Jubilee Hospital
1952 Bay Street
Victoria, B.C.
V8R 1J8

Phone: 250-370-8247
Fax: 250-370-8070
Email: rhonda.lee@viha.ca