SMRT New National Chapter Petition Form

  • In order to form a National Chapter, a petition of at least 25 Members of the society, in good standing, of whom at least 15 are SMRT 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)
    • SMRT Member ID#
    • Membership Type (SMRT 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.
  • Describe the governance model of your proposed chapter:

    • Size of governance committee (i.e., president, vice president, secretary, treasurer; ensure that governing members are SMRT members per our "SMRT Guidelines for Operations")
    • 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
  • Must be a full member of SMRT in good standing.
  • Date Format: YYYY slash MM slash DD
  • (for at least two (2) years following division creation)
  • (income/expenses)