SCOBGYN Society Payment of Dues: 2017

Please make note of change of address and
notify your accounts payable department.

10120 Two Notch Road
Box 340
Columbia, SC 29223
www.scobgynsociety.com

PAYMENT OF DUES: 2019

Annual Dues for the South Carolina Obstetrical and Gynecological Society are now due. Please download this form. Mail your check in the amount of listed for your membership status and return it with this form to Beth Owens, Executive Director, SC Ob/Gyn Society, 10120 Two Notch Road, Box 340, Columbia, SC 29223, (803) 606-4597. You may also pay on-line through our website using PayPal with the form below.

DEMOGRAPHIC UPDATE:

Name*

Preferred Address (2000 chars left)*

Phone #*

Fax #

Email*

Spouse's Name

MEMBERSHIP STATUS:

Please take this opportunity to familiarize yourself with the membership categories of the Society and indicate in the space provided below if your membership status should be changed . Records will be altered accordingly.

Select Your Membership Status* EMERITUS $25 Active or Senior Fellows of the South Carolina Obstetrical and Gynecological Society who have passed their sixtieth birthday and have paid their dues for the current year, may apply to become an Emeritus Fellow. An Emeritus Fellow can hold office and can vote. An Emeritus Fellow will be required to pay dues.
ASSOCIATE $0 Active members of the South Carolina Obstetrical and Gynecological Society who move from this State and continue the practice of obstetrics and/or gynecology, at their request may be maintained as Associate members, not eligible to hold office or to vote, and not expected to pay dues. Associate members are expected to attend at least one meeting every four years or they will be dropped from the rolls of the Society.
ACTIVE $100 Active members must be certified by the American Board of Obstetrics and Gynecology. Membership is restricted to those doctors of medicine practicing in South Carolina and who limit their practice to the overall health care of women.
AFFILIATE $50 Affiliate Membership is reserved for Allied Health Professionals to include PhD’s, other physicians working in women’s health, or Nurse Practitioners involved in women’s healthcare services. Affiliate Members will be invited to attend the Annual Meeting of the Society. Affiliate members will pay one-half of the annual dues. Affiliate members are not eligible to hold office or to vote. Affiliate Members are expected to attend at least one meeting every four years or they will be dropped from the rolls of the Society.
CANDIDATE $50 Candidate members are those physicians who have successfully completed residency training in obstetrics and gynecology and are actively pursuing board certification in the specialty. Candidates must achieve Active status within six years of passing the written exam, excluding time spent in a Board-approved fellowship. Candidate members shall pay one-half the annual dues to the society. Candidate members are not eligible to hold office or to vote.

Request to Change Membership Status (2000 chars left)

After you complete the form, click the "Submit" button. Once your form is submitted you will be directed to the online payment page.

PRINT THIS PAGE AND MAIL TO:

Beth Owens, Executive Director

SC Ob/Gyn Society

10120 Two Notch Road, Box 340

Columbia, SC 29223

Name

Preferred Address

Phone #

Fax #

Email

Spouse's Name

Select Your Membership Status

Request to Change Membership

Thank you for submitting your 2017 Demographic Update and Membership Status. Please use the PayPal link below to securely pay your member dues online. You can also mail a check to:

Beth Owens, Executive Director, SC Ob/Gyn Society
10120 Two Notch Road
Box 340
Columbia, SC 29223

(803) 606-4597

PAYMENT