American Association of Physicists in Medicine
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Member Society of the American Institute of Physics
Send questions regarding application to Jennifer Hudson
AAPM Membership Service Coordinator - 571.298.1365
APPLICATION FOR CORRESPONDING MEMBERSHIP
If you are changing membership types, what is your current type?
----- Choose a Type of Membership ----
Are you engaged in professional, research, or academic activity related to
applications of physics in medicine and biology.
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PERSONAL INFO:
Prefix
First Name
PROFESSIONAL QUALIFICATIONS IN MEDICAL
PHYSICS: (Include Certifications, Committees, etc.)
(Choose a Prefix...)
Middle Initial
Last Name
Title/Position
Birth Date
Gender
CONTACT INFO:
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(Choose Type of Address...)
LIST CURRENT SCIENTIFIC AND PROFESSIONAL
ACTIVITIES RELATED TO MEDICAL PHYSICS:
Department
(If business address)
Institution
(If business address)
Street Address
Street Address
(cont)
City
State/Province
(2 letter abbreviation)
Zip Code
Country
Phone
Fax
Email
Web Address
EDUCATION: (List most recently received degree first)
Institution
Major
Dates Attended (Month & Year)
From:
From:
From:
Degree Received (or Equivalent)
To:
To:
To:
PROFESSIONAL EXPERIENCE: (List most recent experience first, enter N/A if not applicable)
Employer
Title/Position
Dates (Month & Year)
From:
From:
From:
Duties (be specific)
To:
To:
To:
Rev 01/2016
TWO REFERENCES REQUIRED:
A letter of recommendation from each of two Full Members of the AAPM who are familiar with you and your qualifications for
membership must be included to complete an application for membership to the AAPM, including an application to change
membership status; with the exception of Junior to Full. Both letters of recommendation must be received before an
application can be processed. Please list the names and Member Id# (if known) of the two Full or Emeritus AAPM Members
whom you have asked to sponsor your membership:
1.
2.
To verify that the AAPM Members above are Full or Emeritus, please visit: http://www.aapm.org/memb/full/
Financial Assistance through the Partners in Physics Program
For persons living in countries that AAPM deems as developing, who are applying for Corresponding Membership, financial assistance may
be available. Please visit the AAPM Developing Country list at http://www.aapm.org/org/developing_countries.asp to see if your country of
residence is on the list. If so, you may answer the following question:
Do you require Financial Assistance? No
ADDITIONAL INFO:
Have you ever been a member of AAPM?
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As an AAPM member, I will abide by the AAPM Code of
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Ethics.
Are you new to the Medical Physics Profession?
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How did you hear about AAPM?
Check all that apply:
AAPM Member
A Professor/Mentor
AAPM Meeting
RSNA
ASTRO
ABS
Other (Please specify in right panel)
If you are not new to the profession, what led you to join
AAPM now?
Scientific
Education
Professional
Other (Please specify in right panel)
FEES & OPTIONS: (refer to www.aapm.org for yearly dues)
Electronic version of the Medical Physics Journal is
----Choose----
included with corresponding membership. Would you
like to add a print version for an additional fee of $162?
Rev 01/2016
Non-USA members typically receive Physics Today
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online only. Would you prefer to receive Physics Today
in print at no additional cost?
New Members
$50 Non-Refundable Application Fee
(You will be e-mailed an electronic invoice.)
Change of Status
No application fee
Partners in Physics Applicants
If accepted into the PIP program, application fee waived
*E-Mail this word document as an attachment to: membership@aapm.org
Be sure to attach an ID style photograph of yourself in JPG format in your
Application email for use in the AAPM Membership Directory**
For Office Use Only
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Start Date
Rev 01/2016
By submitting this application, I indicate that I have read and agree to adhere to and abide by all the terms and
conditions of the agreement below.
Medical Physics Online Subscriber Agreement
1. THIS AGREEMENT between you (Member or you) and the American Association of Physicists in Medicine
(AAPM) grants you the right to access the online version of the Medical Physics journal (Medical Physics Online)
for which you maintain, through membership in AAPM, a current subscription, subject to the terms and conditions
set forth in this Agreement.
Terms and Conditions
2. Authorized Users
AAPM grants to the Member online access to Medical Physics Online. This grant extends only to the Member
individually and may not be transferred to, or extended to, others.
You agree to maintain your User ID and password as private and confidential information. Unauthorized use of the
Member's User ID and password for online access to Medical Physics Online, with or without the Member's
knowledge, is a breach of this Agreement and a violation of AAPM's copyrights.
3. User Identification and Password
A few days after you indicate your acceptance of this Agreement, a message will be sent to your e-mail address.
This message will direct you to the Online Journal Registration Center of AAPM's publishing services provider, the
American Institute of Physics (AIP), where you will be able to select a User ID and Password of your own
choosing.
4. Permitted Use
The Member is permitted online access to Medical Physics Online, and may download, save, or print text, search
results, or other information from the journal solely for the private use or research of the Member. The Member
may only use this online access in a way that conforms with all applicable laws and regulations.
AAPM grants the Subscriber permission for brief quotations from Medical Physics Online article texts, with the
customary acknowledgment of the source, subject to the restrictions, if any, set forth in the article.
The Member specifically agrees that use by the Member other than indicated above is a violation of the terms of
this Agreement.
5. Prohibitions on Certain Uses
Altering, recompiling, systematic or programmatic copying, reselling, redistributing, publishing or republishing
(beyond the brief quotations permitted under Section 4) of any journal text, output, search results, or other
information from Medical Physics Online, or any portion thereof, including without limitation, copyright, proprietary
and/or other legal notices contained therein, in any form or medium is prohibited. Systematic downloading, service
bureau redistribution services, printing for fee-for-service purposes and/or the systematic making of print or
electronic copies for transmission to non-subscribers or non-subscribing institutions (such as in interlibrary loan)
are prohibited. Downloading portions of Medical Physics Online for the purpose of creating pre-loaded systematic
and persistent local copies (not including transient, dynamic caches) for redistribution is prohibited. All rights not
expressly granted are reserved to AAPM. The Member may not circumvent access control systems or use the
computer systems or services of the publishing service provider, AIP, to make any attempt to gain unauthorized
access to any other system or network.
AAPM shall not be required to distribute, and Member shall not redistribute, Medical Physics Online to a country
where the export thereof is prohibited by U.S. law or regulation.
6. Duration of Agreement
This Agreement will become effective upon acceptance by the Member and, subject to the terms and conditions of
this Agreement, will remain in effect while the Member maintains subscription rights via current membership in
AAPM. This Agreement will terminate:
a. Subject to (b.) and (c.) below, if subscription rights expire based on lapsed membership in AAPM.
b. Following thirty (30) days' prior written notice that any term or condition of this Agreement is violated for
any reason, knowingly or unknowingly, provided that violation is not remedied with all reasonable haste
upon notification. The foregoing notwithstanding, AAPM reserves the right to suspend access to the
service immediately upon detecting a breach of this Agreement. AAPM will notify the Member as soon as
possible and always within three (3) days of any such suspension of service.
Rev 01/2016
c.
Following thirty (30) days' prior written notice by AAPM of any change in the terms of this Agreement,
receipt by AAPM of notice from the Member in writing, or by e-mail or by fax that the Member does not
accept such change or changes. (In the absence of any such objection by the Member, AAPM's new
terms shall apply.)
7. Copyright
Medical Physics Online and its content, including abstracts, are copyrighted by AAPM and are subject to all
applicable copyright, database protection and other rights of AAPM as the owner and publisher under the laws of
the United States and other countries. Copyright notices in Medical Physics Online may not be removed,
obscured, or modified in any way.
8. Failure of Performance
Following online access approval, the Member will be permitted to attempt online access to Medical Physics
Online at any time. AAPM, however, will not be liable for any delay, downtime, transmission error, software or
equipment incompatibilities, force majeure or other failure of performance. AAPM will use commercially
reasonable efforts to correct any material performance problem brought to its attention and may suspend
performance pending such correction.
9. Official Version of Record
AAPM will use commercially reasonable efforts to ensure that the online version of the Medical Physics journal
corresponds in content with the print version, but AAPM does not guarantee that it does. In the event of any
discrepancy between the print and online versions, the print version will be the official version of record.
10. Disclaimer of Warranties; Limitation of Liability; Indemnification
AAPM warrants that it is entitled to grant the licenses granted in this Agreement. EXCEPT AS SET FORTH IN
THE PRECEDING SENTENCE, AAPM MAKES NO WARRANTY OR REPRESENTATION OF ANY KIND,
EXPRESS OR IMPLIED, WITH RESPECT TO MEDICAL PHYSICS ONLINE, INCL UDING ITS QUALITY,
ORIGINALITY, SUITABILITY, SEARCHABILITY, OPERATION, PERF ORMANCE, MERCHANTABILITY OR
FITNESS FOR A PARTICULAR PURPOSE. AAPM SHALL NOT BE LIABLE FOR: EXEMPLARY, SPECIAL,
INDIRECT, INCIDENTAL, CONSEQUENTIAL OR OTHER DAMAGES, ARISING OUT OF OR IN CONNECTION
WITH THE SUBSCRIPTION OR LICENSES GRANTED HEREUNDER, THE USE OR INABILITY TO USE
MEDICAL PHYSICS ONLINE, AAPM'S PERFORMANCE UNDER THIS AGREEMENT, TERMINATION OF THIS
AGREEMENT BY AAPM OR THE LOSS OF DATA, BUSINESS OR GOODWILL, EVEN IF AAPM IS ADVISED
OR AWARE OF THE POSSIBILITY OF SUCH DAMAGES. IN NO EVENT SHALL THE TOTAL AGGREGATE
LIABILITY OF AIP FOR ANY CLAIMS, LOSSES OR DAMAGES ARISING OUT OF ANY BREACH OR
TERMINATION OF THIS AGREEMENT EXCEED THE TOTAL AMOUNT PAID BY THE MEMBER TO AAPM
FOR THE ONLINE JOURNAL SUBSCRIPTION, BUT NOT LESS THAN TWENTY- FIVE DOLLARS ($25.00),
FOR THE CURRENT SUBSCRIPTION YEAR IN WHICH SUCH CLAIM, LOSS OR DAMAGE OCCURRED,
WHETHER IN CONTRACT, TORT, OR OTHERWISE, INCLUDING WITHOUT LIMITATION DUE TO
NEGLIGENCE. The foregoing limitation of liability and exclusion of certain damages shall apply regardless of the
success or effectiveness of other remedies. No claim may be made against AAPM unless suit is filed thereon
within one (1) year after the event giving rise to the claim.
The Member assumes sole responsibility for all use of Medical Physics Online by the Member. In the event of a
breach of this Agreement by the Member, the Member agrees to indemnify and hold AAPM harmless from and
against any and all claims, liabilities, damages, expenses (including attorneys' fees and experts' costs, penalties
and fees, if any, for the enforcement of this Agreement and otherwise for AAPM's defense of indemnified claims),
losses and threatened losses arising from, or in connection with, that breach, including without limitation, claims of
unauthorized use.
11. General
This Agreement constitutes the entire agreement between the parties and supersedes any prior communication
between the parties with respect to the subject matter hereof. Subject to termination under Section 6, this
Agreement may be amended only by a written instrument signed by both parties. The headings used in this
Agreement are for convenience only and are not to be considered in construing the terms of this Agreement. The
Subscriber may not assign or transfer its rights under this Agreement. The provisions of Sections 2, 4, 5, 7, 9, 10,
11 and 12 hereof shall survive any expiration or termination of this Agreement.
This Agreement will be governed by, and construed in accordance with, the laws of the State of New York,
applicable to contracts entered into and fully performed in the State of New York. Any action arising out of, or
relating to, this Agreement or Medical Physics Online shall be brought in courts situated in Nassau County, New
York and the parties consent to the jurisdiction of such courts.
Rev 01/2016