MEMBERSHIP APPLICATION Apply for SASMA Membership Complete the form below to submit your membership application, Our team will review your information and contact you regarding the next steps Applications are reviewed by the SASMA Membership Committee Full Name * Email Address * Phone Number * Country of Residence * Medical Specialty * Select SpecialtyPlastic SurgeryDermatologyAesthetic MedicineOphthalmologyENT SurgeryOral & Maxillofacial SurgeryResident PhysicianOther Medical Degree / Certificate (Optional) Message (Optional) I confirm that the information provided is accurate and complete.