All posts by jeff

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memberinfo

Fall Conference Registration

Please check that your contact information is accurate before registering. If you need to update your information please visit your profile settings.

Contact Information

Name: [am4user]
Email: [am4user var=email]
Home Phone: [am4user var=phone]
Address: [am4user var=street]
City: [am4user var=city]  State: [am4user var=state]  Zipcode: [am4user var=zip]

Update My Contact Information

Registration

If someone other than yourself is paying for this registration please provide there name below.

Name: 

Details go here.  Price? Options?

nonmemberform

ACE Approval
Individual Course
Non-Member Price

    General Directions

    You will receive an invoice by email for the required $30 processing fee for each ACE request.

    The following items must be submitted with this completed form:

    • A syllabus or course description

    • A copy of your transcript with a "C" or better. The transcript must indicate if credits earned are quarter semester credits or semester credits.

    Course Syllabus or Description

    Transcript

    You will receive an invoice by email for the required $30 processing fee for each ACE request.

    Contact Information

    Name

    Mailing Address

    Daytime Phone Number

    Email Address

    Licensed Modality

    RadiographyUltrasoundCV/InterventionalMammographyCTRadiation TherapyNuclear MedicineMRIOther

    Identification of Activity(Separate forms must be submitted for each course)

    Type of Activity

    Title of Activity

    Faculty/Instructor

    Dates of Activity

    Length of Activity

    Location

    Semester Completed (for college courses)

     

    memberform

    ACE Approval
    Individual Course
    Members Only Discount Price

      General Directions

      You will receive an invoice by email for the required $10 processing fee for each ACE request.

      The following items must be submitted with this completed form:

      • A syllabus or course description

      • A copy of your transcript with a "C" or better. The transcript must indicate if credits earned are quarter semester credits or semester credits.

      Course Syllabus or Description

      Transcript

      Contact Information

      Name

      Mailing Address

      Daytime Phone Number

      Email Address

      Licensed Modality

      RadiographyUltrasoundCV/InterventionalMammographyCTRadiation TherapyNuclear MedicineMRIOther

      Identification of Activity(Separate forms must be submitted for each course)

      Type of Activity

      Title of Activity

      Faculty/Instructor

      Dates of Activity

      Length of Activity

      Location

      Semester Completed (for college courses)

        You will receive an invoice by email for the required processing fee for each ACE request.

      Individual Request

      Achievements in Continuing Education (ACE)

      Individual Request for College Courses

      Please select whether you are a current member of the MSRT or a non-member making this request.