ASMIRT Membership Application Form

AUSTRALIAN SOCIETY OF MEDICAL IMAGING AND RADIATION THERAPY

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For eligible practitioners working clinically. (Includes full member benefits)

IF YOUR QUALIFICATIONS WERE OBTAINED OVERSEAS PLEASE CONTACT membership@asmirt.org BEFORE PROCEEDING WITH YOUR APPLICATION

For eligible practitioners not working clinically. Includes Maternity Leave, Sick Leave, Full Time PhD Candidates, Non-Clinical Academic Lecturers and MRS related Commercial Entities (eg Sales Rep). (Member benefits exclude PI Insurance)

For eligible practitioners undertaking an MRPBA Supervised Practice Program (SPP). (Includes full member benefits)

For eligible practitioners who have permanently retired from their engagement within the Medical Radiation Science professions. (Member benefits exclude PI Insurance)

Practitioners who do not hold an ASMIRT recognised relevant qualification in Medical Radiation Science. (Member benefits exclude PI Insurance).

An Australian/New Zealand Medical Radiation Science (MRS) Undergraduate or Graduate Entry Masters (GEM) course only.
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Employer Details

Supervised Practice Program (SPP) (If applicable) / Return to Work

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Supervised Practice Program (SPP) (If applicable) / Return to Work

Supervised Practice Program (SPP) isn't applicable

Add your degree {{ +index + 1 }}

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Application Summary
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Contact
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Ahpra/ASAR Registration Number {{ form_data['contact']['ahpra_number'] }}
Education

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Date Start {{ item['date_end'] | formatDate }}
SPP
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End Date {{ form_data['spp']['end_date'] | formatDate }}
Employer Name {{ form_data['spp']['employer_name'] }}
Employer Address {{ form_data['spp']['employer_address'] }}
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Not applicable
I agree with Terms and Conditions*