P.O. Box 68755 Indianapolis, IN 46268
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Indiana Orthopaedic Society
  • About
    • Board of Directors
    • Donate
    • Contact
  • Membership
    • Pay Dues
    • Application for Full Membership
    • Application for Associates
    • Directory
  • Education
    • Advocacy
    • Maintenance of Certification
    • Annual Meeting
    • Resources
  • Letter from our President
  • About
    • Board of Directors
    • Donate
    • Contact
  • Membership
    • Pay Dues
    • Application for Full Membership
    • Application for Associates
    • Directory
  • Education
    • Advocacy
    • Maintenance of Certification
    • Annual Meeting
    • Resources
  • Letter from our President

    Board Certified Member Application

    Basic Information


    Employment


    Training



    License


    Application Sponsor

    All applicants must have two sponsors to gain membership. 
    Applications and sponsor letters must be completed and mailed or faxed to the IOS office
     no later than May 1.
Submit

OPTIONAL: PRINT AND MAIL OR EMAIL THE FORM
Mail or Email To:
Kellye Mitros
Interim Executive Director

Indiana Orthopaedic Society
P.O. Box 1221
South Bend, Indiana 46624

iosocietydirector@gmail.com
Tel:  (574) 360-4154
PDF IOS Application - Board Certified
File Size: 111 kb
File Type: pdf
Download File

WORD DOC IOS Application - Board Certified
File Size: 32 kb
File Type: doc
Download File

© 2020 Indiana Orthopedic Society

Kellye Mitros, Executive Director ​
PO Box 1221 South Bend, Indiana 46624
Phone: 574-360-4154
Email: iosocietydirector@gmail.com

Membership Information     Leadership     Full Application

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