Become a Participating Member

We welcome your support through your membership in the United States Bone and Joint Initiative (USBJI), the U.S. National Action Network of the worldwide Bone and Joint Decade.

To apply for Participating Membership online, please complete the form below. You may also print a paper form and fax or mail it to USBJI.

Apply for Participating Membership

Participating Membership (non-profit organizations) *

- $ 1,000.00

To have your card automatically charged to renew your membership, check the “I want to contribute this amount every year” box below. Otherwise, your dues will be billed annually to the attention of the primary contact of your organization or corporation.

Please renew my membership automatically.

Total Amount

I am applying on behalf of a non-profit organization.

If you would like to create an account on this site, check the box below and enter a Username If you already have an account please login before completing this form.

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Username

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Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores.

Your Contact Information (Used in mem. and event reg. forms)

Prefix *

First Name *

Middle

Last Name *

Suffix

Credentials/Affiliations

(e.g. MD, FACS)

Title/Position *

Email (Main)

Phone (Main) *

Country

Street Address

Street Address (cont'd)

City

State

Postal Code

Please mention any additional representatives, if any, one per line.

Additional Representatives (name, title, phone, email)

Please confirm you have read USBJI Bylaws *

I confirm

Credit Card Information

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Card Type

Card Number

Security Code

Expiration Date

My billing address is the same as above

Billing Name and Address

Billing First Name

Billing Middle Name

Billing Last Name

Country

Street Address

City

State/Province

Postal Code

By submitting this form, you agree to the following statement:

We agree to abide by the USBJI Bylaws, and understand that annual dues, payable on a calendar year basis, are due at the beginning of every year and up to such time as we inform the USBJI in writing of any desire to change the status of our membership in the organization.

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Become a Participating Member