The Society Of Invasive Cardiovascular Professionals

A corporate membership is a great chance for Cath-Lab Managers to get their staff involved with SICP.

The group rate will be granted to four employees for $170, this is a discount of 15% off the individual rate. In keeping with our membership growth campaign, the four members can renew at the rate of $170 for the second year before it increases the third year to $230.

Facility:
Address:
City:
State:		Zip:
Phone:
Fax:
Contact Email:

Member #1
Name:
Home Address:
City:
State:		Zip:
Email:

Member #2
Name:
Home Address:
City:
State:		Zip:
Email:

Member #3
Name:
Home Address:
City:
State:		Zip:
Email:

Member #4
Name:
Home Address:
City:
State:		Zip:
Email:

Additional Staff members may join at $42.50 each. Please list their contact information below.
Member #5
Name:
Home Address:
City:
State:		Zip:
Email:

Member #6
Name:
Home Address:
City:
State:		Zip:
Email:

Member #7
Name:
Home Address:
City:
State:		Zip:
Email:

Member #8
Name:
Home Address:
City:
State:		Zip:
Email:
Payment Information: VISA MasterCard $170 (+ additional members at $42.50) = total application amount. Credit Card # Exp date (mm/yyyy): Name on Card: Please indicate with your initials that you have read the SICP Membership Pledge: *I certify that I am a qualified health care professional actively working in invasive cardiology.*

Questions? Please call 919-787-4916 or email: membership@sicp.com