ASMS Marketplace

Membership
		Physician Application Fee, Initial - $350
		Mohs Technician Application Fee, Initial - $75
		Physician Annual Dues (Fellow Member Only) - $350
		Physician Annual Dues (Affiliate, Associate, International Members) - $300
		Mohs Technician Annual Dues  - $75
		Examination Fee (Fellow Member Candidates Only) - $225
		EDUCATIONAL MEETINGS
		Fundamentals of Mohs Surgery Course
		Physician (Current ASMS Member) - $1350
		Physician (Non-ASMS Member) - $2000
		Physician (Current Resident) - $800 (Requires Letter From Chief)
		Physician (Slide Review Only - $475 (Requires Previous Fall Course Attendance)
		Mohs Technician (Employed by Member Physician) - $1150
		Mohs Technician (Accompanying Non-ASMS Member Physician) - $2000
		Annual Clinical Symposium
		Physician (Current ASMS Member) - $425
		Physician (Non-ASMS Member) - $600
		Current Resident - No Charge (Requires Letter from Chief)
		Mohs Technician (Current ASMS Member or Employed by ASMS Member Physician - $350
		Mohs Technician (Non-ASMS or Employed by Non-Member Physician) - $500
		EDUCATIONAL PROGRAMS/SERVICES
		Peer Review (Participation Mandatory for Fellow Members - Fee Included in Annual Dues)
		Peer Review (Participation Voluntary for Non-Fellow Members Only) - $50 Per Case
		Clinical Observational Preceptorship Program (3 Weeks Completed Over 2-Year Period) - $1500
		PRACTICE RESOURCES
		Textbook
		Textbook: Mohs Surgery: Fundamentals and Techniques - $165
		Patient Information Brochures
		(Price Reflect Increase Effective January 1, 2006.  Price Includes Shipping Within Contiguous U.S. Only)
		ASMS Member Rate:     Brochures Sold in Packages of 50 Only
		1-5 Packages - $38 Ea.
		6-10 Packages - $36 Ea.
		11-15 Packages - $34Ea.
		16 or More Packages - $32 Ea.
		Non-ASMS Member Rate:  Brochures Sold in Packages of 50 Only
		1-5 Packages - $72 Ea.
		6-10 Packages - $67 Ea.
		11-15 Packages - $62 Ea.
		16 or More Packages - $57 Ea.
		Shipping Outside Contiguous U.S. - $25 (Flat Rate)
		Total Number of Packages:
		Total Order Cost
		Mohs Lecture Slide Set (Available to Members Only)
		35 mm Slides - $85
		CD-ROM - $125
		CORPORATE RESOURCES
		Exhibitor Fee (Standard 6-Foot Draped Table):
		Fundamentals of Mohs Surgery Course - $1000
		Annual Clinical Symposium - $1000
		Educational Grant: (Specify Amount)
		Fundamentals of Mohs Surgery Course
		Annual Clinical Symposium
		Mailing List Purchase:
		Educational (One-Time Use – Attach Sample Mailing) - $300
		Commercial (One-Time Use) - $500
		BILL TO: (Please type or print clearly)