Application for Membership

The Canadian Society of Clinical Neurophysiologists (CSCN)  represents neurophysiologist and those in neurophysiology training across Canada.

As a member of the CSCN, you are automatically a member of the Canadian Neurological Sciences Federation (CNSF).

Membership runs on a calendar year and is renewable annually.

Contact Information
First Name
Last Name
Position/Title
Hospital or Office/Business Address
Phone
Email
Home Address/Mailing Address
Phone
Email

Education/Professional Experience
Education Experience
Enter as 'Degree, Institution, Dates' - one line per entry
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Residency Training
Enter as 'Field, Institution, Dates' - one line per entry
Add Line
Fellowship Training
Enter as 'Field, Institution, Dates' - one line per entry
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Post Fellowship Plans
If currently in fellowship - indicate post-fellowship plans

Provincial Royal College Medical License
Province of Licensure
Dates Valid

EEG or EMG Experience
Education in Clinical Neurophysiology, EEG or EMG
Enter as 'Education Type, Institution, Dates' - one line per entry
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Appointments in EEG or EMG
List nature and dates of appointments held in clinical neurophysiology, and the number of EMG and EEG interpretations performed per year.
Enter as 'Nature of Appointment, Date, Number/Year' - one line per entry
Add Line

Membership Categories
Annual fee per calendar year - $380 (Canadian) Full Member applicants are physicians certified in Neurology or PM&R by the Royal College of Physicians and Surgeons of Canada or licensed by the College of Physicians and Surgeons of any Province of Canada, or equivalent certification to practice. Full members have passed their EEG and/or EMG exam through CSCN or equivalent (documentation required).
Fellowship year of
Program director's name
Annual fee per calendar year - $80 (Canadian). Junior Member applicants must be registered in a Canadian fellowship training program in clinical neurophysiology, or a related subspecialty fellowship, recognized by the Royal College of Surgeons of Canada. Upon successful completion of fellowship training, Junior members will be promoted to Full Member status.
Specialty / Field:
Annual fee per calendar year - $250 (Canadian) Associate Member applicants are MDs or PhDs, engaged in the research, or the practice of EEG, EMG, or clinical neurophysiology, or are in electroencephalographic, electromyographic or clinical neurophysiological research, and do not meet the criteria for Full membership.
Protection of Privacy Information
The CNSF complies with the principles of the Personal Information Protection and Electronic Documents Act (PIPEDA). We will use the personal information collected on this form for processing this application. Unless you advise the secretariat office otherwise, we will use your contact information to disseminate CNSF, and CNSF Congress information, disseminate society information, and conduct society business. We do not loan, sell or rent our member lists.
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