Nevada Society of Radiologic Technologists

NvSRT STUDENT MEMBERSHIP $20.00

Student Membership Application

Last Name: *

First Name: *

Email: *

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Mailing Address: *

City: *

State: *

Zip Code: *

Contact Phone: *

School Enrolled *

Graduation Date: *

If you would like to join ASRT, please visit:
https://www.asrt.org/membership/join-asrt

ASRT Number

New Member *

Membership dues may be submitted by one of the following methods:

Electronically
- Complete the form to the right and click "Submit" at the bottom of the form.
- After you click "Submit", the form will disappear and scroll to the bottom of the page and click on the "Buy Now" button.
- This will take you to the secure PayPal site where you can pay for your membership with your PayPal account or by credit or debit card.
- ** NOTE: You must submit the following form AND pay for your membership through the secure website, PayPal, in order to complete the electronic membership application process.

By Mail
- Printable Application
- Please make checks payable to NvSRT
- Mail the form along with your payment to:

Our Current Dues:

Student membership to the NvSRT is

a two year membership.

For example: June 1, 2018 to May 31, 2020.