CANADIAN SOCIETY FOR AESTHETIC

PLASTIC SURGERY

SOCIÉTÉ CANADIENNE DE CHIRURGIE

PLASTIQUE ESTHÉTIQUE

1788 – 1111 West Georgia St

Vancouver, BC V6E 4M3
info@csaps.ca t: 236.889.1344
www.csaps.ca f: 604.669.4516

ASSOCIATE CANDIDATE APPLICATION

RE: __________________________________________________

I attest that this candidate is a plastic surgeon in the first two (2) years of practice. I have personal
knowledge of this candidate’s competence and ethical standards.

(This information will remain the property of the Canadian Society for Aesthetic Plastic Surgery
and will be strictly confidential.)

This application with a copy of the candidate’s CV must be submitted to the Secretary prior to July
15th to be considered at the Annual Business Meeting. The initial application fee of $200.00 is
payable after the application has been reviewed and accepted by the executive and presented at the
Annual Business Meeting. Annual dues of $200.00 will apply.

Candidates may reapply for full membership after completion of two (2) years in practice. The
standard application fee of $500.00 for full membership will be waived.

Sponsor #1

____________________________ ________________________________ ___________

Name Printed Signature Date

Sponsor #2

____________________________ ________________________________ ___________

Name Printed Signature Date

*Please note that the sponsor must be an active member of the Canadian Society for Aesthetic
Plastic Surgery and should be practicing in the candidate’s immediate geographical area and/or
someone the applicant has worked with in the course of their professional practice. A member
may not sponsor a partner, an associate or a relative.