Member Online Application OS Member Application OS The ASC welcomes members living outside of Australia. To complete your membership application to the Australian Society Of Cytology online, as quickly and easily as possible, you will already have a copy of your qualification certificate scanned and saved on your computer; ready to upload to us, Your Visa or MasterCard on hand to enter your details. Please note all prices are in Australian Dollars (AUD). Title --- Select -- Dr Mrs Ms Miss Mr Last * Last Name Name * First Name Date Of Birth * (Click inside box) Laboratory * (Laboratory or workplace name) Email * (Please enter your email address) Postal Address Postal Address Postal Address Postal Address Town Town State State Postcode Postcode Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Côte d'Ivoire Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country Qualifications * Bachelor (Science) Masters (Science) CTASC CTASC (Gyn) CTASC (NGyn) FASC PhD MBBS MD FRCPA Institution Of Highest Qualification * (Name Of University etc.) Year * (Year Obtained) Cytology Experience * (Please include experiences with time frames) Proposer And Seconder (Must be either Medical or Non-Medical financial members of the Society) Proposer Contact Phone Seconder Contact Phone Categories Of Membership Medical (Specialist) $245.45 Members are specialists who are registered medical practitioners who engage in the practice of Cytology. Medical (Registrar) $186.36 Members are registered medical practitioners who engage in the practice of Cytology. Non Medical $186.36 Members are graduates of a degree course in Medical Laboratory Science (or equivalent) from a recognised tertiary institution, or persons who hold the CT(ASC) who are not registered medical practitioners but who engage in the practice of Cytology. Associate $122.73 Members are persons interested in Cytology not eligible to be Medical or Non-Medical members. (Note: Associate members do not have the right to vote in the affairs of the Society, but may participate in all other activities of the Society.) Please Also Note A once off New Members Joining Fee of $50 is also charged (and for past members who's membership has lapsed for more than 4 years). How Would You Like To Join Us? * Medical Specialist Medical Registrar Non Medical Associate Current Membership Status * --- select --- I'll be a new member I am a current member My membership expired 1 year ago My membership expired 2 years ago My membership expired 3 years ago My membership expired 4 years ago My membership expired 5+ years ago Hard Copy Cytoletter Posted ($40) * Yes Please Post No thank you Total in AUD Including G.S.T. Attach Bsc/Phd Qualification * Drop a file here or click to upload Choose File Maximum upload size: 8MB Payment (Your credit card will only be deducted if your membership application is successful) Security Protocols adopted by this website: If you look in the browser window at the top of the screen, you will see a padlock. The website has a 2,048 bit encryption SSL by Comodo™. Credit Card Type * Visa Mastercard Name On Card * Card Number * Card Number Card Number End Month 1 2 3 4 5 6 7 8 9 10 11 12 End Month End Year 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 End Year On back of card On back of card Acknowledgement * I accept (By checking this box, and clicking submit below, you acknowledge the information is true and correct in every way and that if your membership to the Australian Society Of Cytology Inc. is successful, your credit card will be deducted for the amount shown in total.) Submit If you are human, leave this field blank.