REGISTER MEMBERSHIP REGISTRATION Please complete the data below. *fields are required. First Name* Last Name* E-mail* Confirm E-mail Phone* Password* Confirm Password Degree* MD PhD DO Other Comment if "other" Specialty* Select Specialty Anesthesiology Cardiology Clinical Immunology/Allergy Critical Care Medicine Dentistry Dermatology Diagnostic Radiology Emergency Medicine Endocrinology and Metabolism Family Practice Gastroenterology/Hepatology General Internal Medicine General Surgery Geriatric Medicine Hematology/Oncology Hepatology Medical Genetics Infectious Disease Internal Medicine Nephrology Neurology Neurosurgery Nuclear medicine Obstetrics / Gynecology Occupational Medicine Oncology Ophthalmology Orthopedic Surgery Otolaryngology Pathology Pharmacy Pediatrics Physical Medicine and Rehabilitation Plastic Surgery Psychiatry Public Health and Preventive Medicine Radiation Oncology Radiology Rheumatology Surgery Transplant Urgent Care Urology Other Employer Name* Practice State* Select State Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Minor Outlying Islands Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas U.S. Virgin Islands Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Other Country Membership Description:Lifetime member - $500Full member - one year membership - $100Trainee member (resident and fellow), one year membership - $25Junior member (in the process of matching to a program), one year membership - $25 Associated members are for non-physicians (not board certified) health care workers (Please contact us for registration). Membership Type* Lifetime Member - 500 USD for LifetimeFull Member - 100 USD per 1 year - for 1 time. Trainee Member - 25 USD per 1 year - for 1 time. Associated Lifetime Member - 500 USD for LifetimeAssociated Full Member - 100 USD per 1 year - for 1 time. Junior Member - 25 USD per 1 year - for 1 time. Expected Graduation Year (Required only for trainee registration) The following are not required fields. Chinese Name Would you like to join ANACP member WeChat Group? Yes No Not applicable Medical School Employer Address, City, State, Zip Interest in Position in ANACP Executive Committee Education Committee Membership/Website Committee Finance Committee Advocacy Committee Log in | Lost your password?
