Donation form | International College of Surgeons, US Section

Pay your ICS-US Section dues here.
Basic annual dues $295.
Surgical Specialty Group Donation $30.
Alliance Dues $40.
Additional Donation $125.

Or make any other payment in an amount you designate.

Make a contribution to the ICS-US Section on this page to support projects and programs like:

Surgical Teams
Research Scholarships
Continuing Medical Education
Disaster Relief
Building Fund

Make sure to indicate how you wish your donation to be used in the field below.

Full Name

Address

Email Address

Payment Purpose

Enter Donation Amount Here

Total paid

Payment Information

Amount to Charge :

Payment Method:

Enter the name on the bank account according to the information shown on your bank statement. The account number and routing number can be copied from the lower left corner of the check.

Bank Name:
Bank Account Holder Name:
Routing Number:
Account Number:
Account Type:

Name on Card:

Card #:

Expires:

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