NCDS Membership and Application
Membership Application
The Northern California Dermatology Society
___________________
A California Public Benefit Corporation
The Northern California Dermatology Society (NCDS) has no voting members. The policy contained herein describes the qualifications, dues and benefits of membership in NCDS. The primary objectives and purposes of this corporation shall be:
1. Provide medical education and aid in the dissemination of new knowledge and techniques in dermatology among Northern California dermatologists and dermatology physician extenders
2. Promote public education and raise public awareness of important dermatology issues in our communities
3. Improve dermatology access for the uninsured and underinsured and otherwise socially disadvantaged
4. Share common issues and strategies for practice management and facilitate collegiality among dermatologists in Northern California
QUALIFICATIONS OF MEMBERS
The qualifications for membership in NCDS are as follows:
(a) The annual dues payable to the corporation by members shall be $100 for dermatologists and $50 for physician extenders.
MEMBERSHIP MEETINGS AND BENEFITS
Members of NCDS are entitled to attend regular educational meetings sponsored by all or part of the NCDS including but not limited to journal clubs, guest lectures and case presentations. Nonmembers and those interested in membership in NCDS may also attend a meeting if invited by and accompanied by a member. Nonmembers are not allowed to attend more than 2 meetings in any calendar year.
NONLIABILITY OF MEMBERS
A member of this corporation is not, as such, personally liable for the debts, liabilities, or obligations of the corporation.
TERMINATION OF MEMBERSHIP
(a) Grounds for Termination. The membership of a member shall terminate upon the occurrence of any of the following events:
(1) Upon his or her notice of such termination delivered to the president or secretary of the corporation personally or by mail, such membership to terminate upon the date of delivery of the notice or date of deposit in the mail.
(2) Upon a determination by the board of directors that the member has engaged in conduct materially and seriously prejudicial to the interests or purposes of the corporation.
(3) Failure to pay dues on or before their due date, such termination to be effective thirty (30) days after a written notification of delinquency is given personally or mailed to such member by the secretary of the corporation. A member may avoid such termination by paying the amount of delinquent dues within a thirty (30) day period following the member's receipt of the written notification of delinquency.
I, ___________________________am qualified and wish to become a member of NCDS
Address:________________________________________________________________
Phone:_______________________
Email:_______________________
Signature________________________________ Date____________________________
Approved by the BOD:
Name: ___________________ ___________________ __________________
Signature: ___________________ ___________________ __________________
Date: ___________________ ___________________ __________________
The Northern California Dermatology Society
___________________
A California Public Benefit Corporation
The Northern California Dermatology Society (NCDS) has no voting members. The policy contained herein describes the qualifications, dues and benefits of membership in NCDS. The primary objectives and purposes of this corporation shall be:
1. Provide medical education and aid in the dissemination of new knowledge and techniques in dermatology among Northern California dermatologists and dermatology physician extenders
2. Promote public education and raise public awareness of important dermatology issues in our communities
3. Improve dermatology access for the uninsured and underinsured and otherwise socially disadvantaged
4. Share common issues and strategies for practice management and facilitate collegiality among dermatologists in Northern California
QUALIFICATIONS OF MEMBERS
The qualifications for membership in NCDS are as follows:
- Board certified or board eligible dermatologist. Exceptions to be considered by the Board of Directors on a case by case basis.
- Physician extender (nurse practioner or physician’s assistant) working for a member
- Practice location in Northern California
(a) The annual dues payable to the corporation by members shall be $100 for dermatologists and $50 for physician extenders.
MEMBERSHIP MEETINGS AND BENEFITS
Members of NCDS are entitled to attend regular educational meetings sponsored by all or part of the NCDS including but not limited to journal clubs, guest lectures and case presentations. Nonmembers and those interested in membership in NCDS may also attend a meeting if invited by and accompanied by a member. Nonmembers are not allowed to attend more than 2 meetings in any calendar year.
NONLIABILITY OF MEMBERS
A member of this corporation is not, as such, personally liable for the debts, liabilities, or obligations of the corporation.
TERMINATION OF MEMBERSHIP
(a) Grounds for Termination. The membership of a member shall terminate upon the occurrence of any of the following events:
(1) Upon his or her notice of such termination delivered to the president or secretary of the corporation personally or by mail, such membership to terminate upon the date of delivery of the notice or date of deposit in the mail.
(2) Upon a determination by the board of directors that the member has engaged in conduct materially and seriously prejudicial to the interests or purposes of the corporation.
(3) Failure to pay dues on or before their due date, such termination to be effective thirty (30) days after a written notification of delinquency is given personally or mailed to such member by the secretary of the corporation. A member may avoid such termination by paying the amount of delinquent dues within a thirty (30) day period following the member's receipt of the written notification of delinquency.
I, ___________________________am qualified and wish to become a member of NCDS
Address:________________________________________________________________
Phone:_______________________
Email:_______________________
Signature________________________________ Date____________________________
Approved by the BOD:
Name: ___________________ ___________________ __________________
Signature: ___________________ ___________________ __________________
Date: ___________________ ___________________ __________________
NCDS Membership Renewal Form
If you are already a member of NCDS, please complete the abbreviated renewal form. This year’s dues are $100 for physician members and $50 for physician extenders. Please renew your membership by sending a check made payable to the Northern California Dermatology Society or NCDS, to C/0 Jeff Sugarman, MD, 2725 Mendocino Avenue, Santa Rosa CA 95403.
Please fill out and include the bottom of this letter in your renewal, for each member who is renewing. Memberships run from July 1st to June 30th.
Please fill out and include the bottom of this letter in your renewal, for each member who is renewing. Memberships run from July 1st to June 30th.
2020-2021 Northern California Dermatology Society renewal form
Name: ______________________________________________________________________________
Address: __________________________________________________________
Phone: _______________________ Email:_______________________
Circle one: Physician ($100)Physician extender ($50)
Additional (tax deductible) donation: $ _____________
Signature ________________________________ Date______________________