Indiana Society of Radiologic Technologists

The ISRT membership year begins on February 1 and ends on January 31 of the following year. Individuals may join the ISRT at any time during the year. Membership applications received prior to the Annual Conference will be processed for the current year and will expire on January 31. Membership applications received after the Annual Conference will automatically be processed for the new membership year, which begins on February 1. Dues are nonrefundable.

Are you a new applicant or renewing member? (*)
New Member ApplicantCurrent/Previous Renewing Member
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If renewing, what year and name have you been a member previously?

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First Name, Middle Initial, Last Name (*)

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Professional Creditentals

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Mailing Address (*)

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City and State (*)

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Zip Code (*)

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Primary Email (*)

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Secondary Email

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Gender (*)
FemaleMale
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Date of Birth (*)

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Phone number with area code

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ARRT Number & Expiration Date (Technologists only)

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Please selet the appropriate response(s) in each category. This information is confidential and truly helpful for the ISRT to serve you. STUDENTS: please skip to the next page.

Primary ARRT Certification
R RadiographyN Nuclear MedicineT Radiation TherapyS Sonography (ARRT)MR MRI
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Secondary ARRT Certification - hold down the Ctrl key to select more than one option
BD Bone DensitometryBS Breast SonographyCI Cardiac InterventionalCV Cardiovascular InterventionalCT Computed TomographyM MammographyMR Magnetic ResonanceQM Quality ManagementRRA Registered Radiologist AssistantS Sonography (ARRT)VI Vascular InterventionalVS Vascular Sonography
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Please list any other certifcations you hold (ARDMS, NMTCB, etc.)

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In which area do you spend more than half your time?
Radiography (CT-MR-QA-Mammo-IR etc.)Nuclear MedicineRadiation TherapySonographyOther
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In what position do you spend more than half your time?
Bone DensitometryCardiac InterventionalComputed TomographyCorporateDosimetryEducation (Program Director/Instructor)Fusion (PET/CT)IndustrialInformatics (Computer Systems)Magnetic ResonanceMammographyManagement (Supervisor/Chief Tech)Nuclear MedicineQuality Assurance/AssessmentRadiation TherapyRadiographyRadiologic NurseRadiologist Assistant or RPAReasearchSimulationSonographyVascular InterventionalNot currently employed in the Radiologic SciencesEmployed in field other than Radiologic Sciences
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STUDENT: The information below is REQUIRED to complete your membership application. CURRENT STUDENTS please answer all questions in this section. All other applicants please skip to the next page.

Program Name (example: IUPUI, IUN, BSU, etc) and City

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Program Director's Name

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Graduation Date (month & year)

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Indiana Student Permit Number (example: XS001234)

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Would you be interested in serving on an ISRT committee? (*)
Yes
No

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Would you be interested in serving as an ISRT officer? (*)
Yes
No

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Would you be interested in presenting a lecture? (*)
Yes
No

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Please select the membership cateory you are applying for: (*)
Active - 40.00 USDLimited X-ray Machine Operator - 40.00 USDSupporting - 40.00 USDRetired - 20.00 USDStudent - 10.00 USDStudent to Tech Upgrade (only for current students) - 30.00 USD
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Total
0.00 USD

Submit will direct you to the online payment option.