SMRT New Division Petition Form

ISMRT New Division Petition Form

Your Member Number*
Your Name*
First Last
Your Email*
Name of proposed Division:*
Member Support for the proposed Division of the ISMRT*
In order to form a Division, a petition of at least 15 Members of the society, in good standing, of whom at least 10 are ISMRT Full Members, will need to be included.

Please attach the required document (download the template here) with the following information:
- Members Full Name (First, M., Last)
- ISMRT Member ID#
- Membership Type (ISMRT Full, Early Career, Student or Affiliate or ISMRM member)
- Email
- City/State
- Country of Residence
Note: If you have more than a few files to upload, please combine them into a single .zip file.
Drop files here or

Accepted file types: xls, xlsx, csv, doc, docx, rtf, txt, pdf, zip, Max. file size: 2 MB.
Hidden
Governance:*
Describe the governance model of your proposed Division:
- Size of governance committee (i.e., president, vice president, secretary, treasurer; ensure that governing members are ISMRT members per our "ISMRT Guidelines for Operations & Governance of ISMRT Divisions & Divisions Representatives")
- Length of term
- Whether or not they are elected annually
- How these members will be nominated
- A description of what each position is responsible for
Acting Division Representative*
Must be a full member of ISMRT in good standing.
First Last
When will the first division election occur?*
YYYY slash MM slash DD
Proposed schedule of educational meetings:*
(for at least two (2) years following division creation)
Proposed budget:*
(income/expenses)
Potential sponsorship for the division:*

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