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  USAV Membership Application
  and
  Dues Renewal Form


Please select one choice below. The annual dues may be paid by check or credit card on the next page. Your application or renewal will be acknowledged by email. Thank you!
 
 
New Member or Renewal? *
Membership status options: *
USAV-only member - Please select category: *
Dual member - Please select category:
Gender

The address below will be used for directory listing and all correspondence.                     

This section for Residents only - skip if not applicable:                                        

This section for urologists only - skip if not applicable:                                        
Board Certified?
If no, are you board eligible?

                                                                                                      

Are you interested in a future leadership role?
By my application, I hereby agree to abide by the Bylaws of the USAV and Society of Government Service Urologists.

Click "Continue" button below. On the next page you may pay your fees by credit card or by check.

NOTE: Organization dues may be deductible as a professional or business expenses to the extent allowable by law. Dues and other contributions to USAV/SGSU are not deductible as charitable contributions for federal income tax purposes.