MEMBERSHIP APPLICATION

INSTRUCTIONS

The application for membership in the Western Surgical Association is attached below.

There are 4 steps to the application process:

1. Complete the first page of demographic information, including name, address, e-mail address and the name of your sponsor and 2 endorsers. Your Sponsor for membership vouches for your personal character and professional standing. He/She will identify 2 endorsing members of the WSA.
2. Complete the second page of the application. You must verify your agreement with each statement extracted from the bylaws of the WSA.
3. Attach an electronic updated version of your curriculum vitae. Your CV should contain the following subheading and/or information:
   1. Date and Place of Birth
   2. If married, name of spouse
   3. Premedical, Medical and Graduate Education (Residency & Fellowships)
   4. Active Hospital Staff Appointments
   5. Teaching Appointments
   6. Board Certification (date)
   7. Fellowship in ACS (date)
   8. Medical & Surgical Societies
   9. Leadership positions at Hospital/in Community
   10. Publications
4. The applicant and/or sponsor are responsible for verifying with the Secretary's office receipt of the three letters of support by June 1.

Upon receipt of a complete application, including letters of Sponsorship and Endorsement, the Membership Committee of the WSA will review your application and present a slate to the membership. The entire membership will then vote for approval of each proposed member at the Business meeting of the Association at the Annual Meeting in November. Notification of the election will come from the Secretary's office in December.

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