IH Membership Application

Step 1 of 8 - Introduction

If you are applying for ASMBS Membership in conjunction with Registration for any ASMBS educational event, please note the following:

Upon submission of a completed application, the application is sent to the ASMBS Membership Committee for review. It can take approximately 6-8 weeks for approval. Pending members are eligible for the reduced member rate for all educational meeting and symposiums, however all applications MUST be complete, including payment, at least 30 days prior to an event in order for the discount to apply. If your application is not complete, you will not receive a refund reflecting member pricing for any ASMBS Conference.

Application Instructions

Please complete all entries. Missing or incomplete entries will delay application approval. In addition to the completed membership application form, the following items must be submitted:

  1. Recommendation Form* completed by a Regular, Senior, or Associate** member in good standing of the ASMBS. It is the responsibility of the applicant to upload the form at the time of completing this application.
  2. A current Curriculum Vitae (or resume) which includes education and past work experience.
  3. Regular Associate, Associate, and Affiliate Member types: a copy of your state license, registration or certification.

Payment must be received before an application is reviewed. Please allow 4-6 weeks from submission of complete and paid application for review.

* For those applicants who need assistance obtaining a Recommendation Form, please contact ih-membership@asmbs.org

**International applicants should substitute the Member Recommendation Form from an International Member.

The American Society for Metabolic and Bariatric Surgery prohibits discrimination against any member or any applicant for membership because of race, color, gender, national or ethnic origin, age, religion, disability, sex, or any other characteristic protected under applicable federal or state law.

Consent

Your information and privacy is our top priority. By applying to become an ASMBS member, you agree to the terms outlined in the ASMBS Privacy Policy. ASMBS will never sell or provide your information to anyone or any business without your consent. After membership approval, ASMBS will only share your information to the entities outlined in the privacy policy to fulfill your membership benefits. You may opt out of these benefits and may request to have your information removed from ASMBS at anytime.You can read the ASMBS Privacy Policy and if you have any questions or concerns please contact the office.

Provide your consent(Required)
If an ASMBS member referred you to become an ASMBS Member, enter the name of the referring member here. If no member referred you, leave this blank.