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Membership Application

Level
Regular membership (Free) Subscription period: Unlimited

You may apply for membership on the NEURISA website.  The process is automated to allow NEURISA contacts to become members and take advantage of self-service features like adjusting privacy and notification settings.  Complete the process below to become a member. 

Note: this does not enroll you for URISA membership, as it only provides free access to NEURISA website features.

Please contact neurisa@gmail.com with any questions.

Fill in application form

Application form

* Mandatory fields
 

 

*First name
*Last name
*e-Mail
*Organization
Street Address
City/Town
State
ZIP
Title
Phone
*Password
 
 

Personal information

Job title
Website
 

Contact data

Address
City
Postal code
Province/State
Country

Security check

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NEURISA serves Connecticut, New Hampshire, Maine, Massachusetts, Rhode Island and Vermont. NEURISA is a not-for-profit [501(c)(6)] professional organization incorporated in Massachusetts.  Contact NEURISA