Online Application

Thank you for your interest in the SouthEast Texas Clinical Engineering Society. To become a member of our organization, please follow the instructions below:

  1. Please read the By-Laws pertaining to SETCES.

  2. Complete the online form below.

  3. After submitting this form, you will be redirected to PayPal for payment of membership dues. Your membership will not be finalized until payment has been accepted.

*Indicates a required field.

*Is this a new membership, or a renewal?

New Membership

Renewal Membership

*First Name:

*Last Name:

*Title:

*Business Name:

Home Address:

Business Address:

City:

State:

City:

State:

Zip Code:

Zip Code:

*E-mail Address:

Alternate E-mail Address:

Daytime Phone Number:

Business Phone Number:

 

Business Fax Number:
 

*What type of membership are you applying for?

What type of equipment do you work on?

General Biomedical

Radiology

Laboratory

Other:

Are you willing to serve on a committee?

Yes

No

Are you willing to inservice your peers?

Yes

No

I have read and understand the By-Laws. I hereby attest that I will abide by the by-laws pertaining to the SouthEast Texas Clinical Engineering Society.