Affiliate Membership Application

Instructions

Welcome to the NSAA! We look forward to having you as a vital member of the National Surgical Assistant Association. Please fill out the application below.

Select An Option

Affiliate Member $200 Annually

An Affiliate Member is any person who holds a surgical assistant credential other than CSA, medical organizations, medical businesses, and is in good standing with the NSAA. Annual dues for Affiliate Members is $200.

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameBusiness Name

Please select a valid membership option and fee item if exist