2023/2024 MEMBERSHIP DUES 			 

Dear PSS and AZACS Member,

This letter is your 2023/2024 Phoenix Surgical Society dues statement.  Please fill out the bottom of this form and fax back with credit card payment or detach and mail back with your check.  Please retain a copy for your records and receipt.

Dues for 2023/2024

Member of Both PSS and AZ ACS		$450
(Membership in both societies will be confirmed)
Member of PSS only				$550
Honorary Active Members (Retired)		$195
Retired members of either society
The above membership rates include admission to the 2024 Phoenix Surgical Society Meeting.

2024 PSS / AZ ACS CHAPTER MEETING
February 8-10, 2024
Scottsdale Hilton Resort and Villas
6333 North Scottsdale Road
Scottsdale, AZ 85250.

Visit us at
www.phoenixsurgicalsociety.com

PHOENIX
SURGICAL
SOCIETY

3370 N. Hayden Rd., 
Suite 123  PMB 516
Scottsdale, AZ  85251
480-625-9465
info@phoenixsurgicalsociety.com

Phoenix Surgical Society
2023/2024 DUES Statement

						          Please print info below
Full Name		
Full Street Address		
City/St/Zip		
Email		
Phone		
Fax		
				
Please check membership box
□ PSS/AZ ACS Member $450                    □ PSS only Member $550                    □ (HA) Honorary Active Member $195	

Enclosed is my check made payable to Phoenix Surgical Society:  Ck #________

Please charge my credit card:  AMEX, VI,  MC or Discover

Card Number:____________________________________________________________ Expire Date__________ CCV code________

Name on card: ________________________________________________________________________________________________

Full Billing address if different from above: ___________________________________________________________________________

Signature of cardholder: _________________________________________________________________________________________