Online Application for Institutional Membership

By offering this membership opportunity, the Society's goal is to reduce the rate of complications for children undergoing sedation and to continue educating all health care providers on techniques that reduce complications associated with sedation. Join us and be seen as a leader in the field of pediatric sedation who is dedicated to achieving high quality pediatric care.

If you have questions about membership, or have difficulty completing this application please contact Greg Leasure, Membership Manager, at greg@societyhq.com.

Required fields are marked with an asterisk (*).

Administrator

Principal Investigator

Main Contact

Sedation Director

Nurse Manager for Sedation

Nurse Educator for Sedation

From among those listed above, who should we contact to communicate the following?


MEMBERSHIP LEVELS
Click here for summary of benefits and pricing information. Membership year is January 1-December 31 or July 1-June 30 depending on date of payment

PAYMENT INFORMATION
This is a secure transaction system. However, if entering your credit card information online makes you uncomfortable, please pay by check. APPLICATION MUST ACCOMPANY CHECK. Send check to SPS, 2209 Dickens Road, Richmond, VA 23230-2005. SPS Tax ID #26-0357649; 501c3

Accepted Cards

        

Name on Card:
Card Number:
Card Address:
Card Zip Code:
Exp. Date: /
Security code:
For VISA or MasterCard it is on the back of your card in the signature box. The 3-digit code is printed on the right-hand side of your 16-digit credit card number.
For American Express the code is the 4-digit number printed on the front of your card either on the right-hand side directly above the credit card number or the left-hand side directly above the credit card number.