WSA Membership Application

APPLICANT INFORMATION

Welcome to the WSA Membership Application!
Applications are reviewed annually. To be considered for the current year, please submit your application by Sept. 15th

Membership Eligibility
Graduate of an accredited medical school and completed formal residency training

Must be board certified in specialty
Demonstrate an established excellent reputation as a surgeon

Membership shall not be denied because of race, creed, color, or sex. Under special circumstances, renowned surgeons not meeting the above requirements may be granted members

Membership Application Checklist

Copy of your CV
1 WSA Member Sponsor (Name and Email Address required*)
2 WSA Member Endorser (Names and Email Addresses required*)

*An automatic email will be sent to your sponsor and endorsers confirming their support with an option to leave comments. Letters of recommendation are not required.

1. Applicant Information

First Name *This question is required.

Middle Name

Last Name *This question is required.

Credentials *This question is required.

Email *This question is required. This question requires a valid email address.

Date of Birth (MM/DD/YYYY) *This question is required. This question requires a valid date format of MM/DD/YYYY.

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