Únase Ahora Membership Level Individual - $150 (USD) Subscription period: 1 year, on: January 1st Student - $50 (USD) Subscription period: 1 year, on: January 1st Setup Username and Password Email Please enter MEMBER email address Password Retype Password Password must be at least 6 characters long Student Proof You will need to include proof of your student status with this form. Please attach a current schedule, copy of your student ID, or a letter from a faculty member on letterhead. Primary Details Prefix First Name Middle Initial Last Name Suffix Degree or Designation Organization Involvement Organization Involvement Other Professional Information Job Title Company Biography I am willing to share my contact information with other OTIS members I am part of a Teratology Information Service (TIS) If yes, please tell us which TIS you are affiliated with What is your current role at this TIS Contact Information Country Address 1 Address 2 Address 3 City State/Province Postal Code Work Phone Please include country code Mobile Please include country code Web Address I consent to the society sending me email correspondence relating to my membership, meeting attendance, meeting submissions or other society programs. Volunteer as Expert for Media Request(s) Would you be willing to be contacted as an expert for media interview requests that are submitted through the National Office (if yes, you will be a featured "expert" on MotherToBaby.org)? Yes No If yes, please describe your area(s) of expertise: Membership Information Please let us know if there are any committees you would be interested in learning more about Please consider contributing a tax-deductible donation toward the Kay Padgett or Susan Briggs scholarships. Kay Padgett Scholarship Donation (optional) Kay Padgett Scholarship: Offering scholarships to assist OTIS members in attending educational meetings. Kay Padgett was the administrator of the Reproductive Toxicology Center since it was first conceived in the early 1980s. She was instrumental in getting REPROTOX off the ground and in keeping it running. Kay was a familiar voice on the phone to many OTIS members. She helped with connection problems, payment questions, and most other issues. She was a librarian by training and established search algorithms for REPROTOX that were subsequently adopted by the National Library of Medicine. It was typical of Kay to keep working even after being challenged by the disease that ultimately took her life. When it was clear to her that she would not survive, she helped us design automated systems that would replace her. Although, of course, nothing could really replace her. Because Kay was so devoted to the Teratology Information community, we could think of no better memorial than a scholarship to assist OTIS members in attending educational meetings. Susan Briggs Scholarship Donation (optional) Susan Briggs Scholarship: The Susan Briggs Memorial Scholarship Fund is dedicated to the memory of Susan Briggs who passed away on June 28, 2009. Her husband, Jerry, has been Chair of the OTIS Research Committee for many years. According to Jerry, Susan always supported and encouraged his involvement in OTIS. Following her death, the Susan Briggs Memorial Scholarship Fund was established by the OTIS Board of Directors to encourage OTIS members who are not already Research Coordinators to attend the OTIS Midyear Research Meeting to learn more about OTIS research activities. By becoming a member of OTIS, you agree to abide by the OTIS Code of Ethics. Save and Proceed
