Retired & Emeritus Membership Application

Current ASCO members in good standing who meet Emeritus or Retired qualifications are invited to submit an application for review. Applications will be reviewed by member services.

Membership Qualifications:

Retired Membership (50% discount off Physician/Scientist Dues Rate)

Have an active ASCO membership for less than 25 years5

70 years of age or older OR
Fully retired from all professional activities OR
Unable to work due to a disability

Emeritus Membership (free membership)

Have an active ASCO membership for more than 25 years

70 years of age or older OR
Fully retired from all professional activities OR
Unable to work due to a disability

During the application review period, we ask that you refrain from renewing your current membership until a decision is returned. We will follow up within 2-3 business days.

For questions or additional assistance, please email Toni.Lindsey@asco.org or customerservice@asco.org .

1. Please enter your full name, ASCO member ID number, and your contact information.

Name:

ASCO Member ID:

Primary Address:

Home Phone:

Mobile Phone:

Email:

2. Please select which category you are applying for

Retired Membership

Emeritus Membership

Emeritus with JCO Print Add-On ($150.00 - 1 Year Subscription)

3. Please check which of the following eligibility requirements you currently meet

70 years of age or older

Fully retired from all professional activities

Unable to work due to a disability

4. You may also provide any additional information that may be relevant to your application (optional).

Please do not include any medical information or Personal Identifiable Information (PII).

Signature

I hereby certify that the above statements are true and correct to the best of my knowledge.

Date

mm/dd/yyyy

Send me a copy of my responses

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