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FREE OSRT Membership & Free Online CE

The claim form below should be completed and submitted by an Online CE participant who:

  • has registered and paid for five (5) Online CE modules
    using     http://ce.sinclair.edu.
  • lives or is employed in the State of Ohio

Upon submission of the claim form below, your free Online CE session  will be acknowledged via email. Your free OSRT membership will be acknowledged via US mail. You must indicate the official title of the Online CE module you desire as your free CE session. You may review the module listing by clicking the link below. To return to this form, click the back button on your browser. Click here to review module list

Full Name

 

Email Address

 

Social Security Number

 

Home Phone

 

Work Phone

 

I am requesting my free, first-year OSRT membership now because I have completed 5 online CE modules: Yes  

Street Address

 

City, State, Zip

 

Ohio County

 

Are you a member of ASRT?

 Yes  No 

Birthmonth

 

Check all  professional credentials

Radiography (R)
Radiation Therapy (T)
Nuclear Medicine (N)
Sonography (S)
Bone Densitometry (BD)
Computed Tomography (CT)
Cardiovascular-Interventional (CV)
Magnetic Resonance Imaging (MR)
Mammography (M)
Quality Management (QM)
Vascular Sonography 

I am requesting my free Online CE session now because I have already completed 5 Online CE modules. Yes

Type in  the complete title of the free Online CE module you desire.

 

An email will be sent to you to acknowledge approval of your free,first-year OSRT membership and approval/registration of your free Online CE session.