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Membership Renewal Form-Current Members
OSRT Membership Renewal

Thank you for renewing your OSRT Membership. Membership fees are listed in the table below. Multiple year renewals are set at discounted rates. For questions please contact us at:

(866) 405-OSRT (6778) Office
(888) 317-9472 Fax
osrt@osrt.org

Membership Categories
Active Membership: Offered to those who hold registration with a recognized credentialing organization in medical imaging technology.
One Year$35
Two Years$65
Three Years$90
Associate Membership: Offered to General X-Ray Machine Operators (GXMO) and/or those who show an interest and support in promoting the purposes and functions of the OSRT.
One Year$35
Two Years$65
Three Years$90
Members Emeritus: Offered to members age 65, who have held OSRT membership for a minimum of thirty (30) years in good standing. They shall pay no dues and have all rights and privileges of active members.
Please complete all of the following information:
OSRT ID (*)
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Membership Type / Length (*)
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Payment Options (*)
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Last Name (*)
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First Name (*)
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Middle Name
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Email Address (OSRT will not sell) (*)
Please enter a valid email of the form userid@email.com
Alternate Email
Please enter a valid email of the form userid@email.com
Birth Month (*)
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Birth Year (*)
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In the drop-down below, please select the year that best represents when you think you joined OSRT
Year Joined OSRT (*)
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Based on the renewal form received, Please update fields below that are in need of correction.
Leave blank any fields not needing correction.
Gender
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Home Address
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Home City
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State
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Zip Code
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County
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Home Phone-No dashes
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Work Phone
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Cell Phone
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Fax
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Credentialing Organization (Choose One Primary)


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Registry Number
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Credentials (Check one or more)















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Degree (*)
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Position (*)
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Work In (*)
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Are you a member of ASRT?
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Interested in running for an OSRT board position?
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Interested in serving on an OSRT Committee?
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Form Verification (*) Form Verification   Refresh
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Enter the text you see in the text field
  
(*) = Required
STATEMENT

The Ohio Society of Radiologic Technologists (Business Association) is a tax exempt entity under Internal Revenue Code section 501(c)(6).
Notice of Membership Dues

In accordance with Sec. 6033(e) of the IRS, please be advised that 7.5% of membership dues allocated to legislative activities of OSRT, and as such, may not be deductible for tax purposes.

 
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