2025 Kentucky Chapter Dues Payment

Online Dues Payment & Membership Form
Member Information
Name*

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Address

Street Address

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Email*
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Phone Number
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ACS Member ID
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My Products

Associate Fellow Member

$75.00 Quantity

Affiliate Member

$75.00 Quantity

Retired Member

$ Free Quantity

Resident Member

$ Free Quantity

Medical Student

$ Free Quantity

Total

$0.00

Credit Card

Please make checks payable to:

Kentucky Chapter
Linda Silvestri
Department of Surgery
University of Kentucky
800 Rose Street
C224 A. B. Chandler Medical Center
Lexington, KY 40536-0293
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