Membership Application

MEMBERSHIP     Type* Regular Plus! (1 year - $15) Plus! (4 years - $50)       PERSONAL     Salutation Dr. Mr. Ms. Fr. First Name* Middle Initial Last Name* Address 1* Address 2 City* State* AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip* Phone Email* Alternate Email     EDUCATION   School* Other - Please Specify AL - University of South Alabama College of Medicine AL - University of Alabama School of Medicine AR - University of Arkansas for Medical Sciences College of Medicine AZ - University of Arizona College of Medicine AZ - Arizona College of Osteopathic Medicine of Midwestern University CA - Keck School of Medicine of the University of Southern California CA - David Geffen School of Medicine at UCLA CA - Loma Linda University School of Medicine CA - University of California Davis School of Medicine CA - University of California San Diego School of Medicine CA - University of California Irvine College of Medicine CA - University of California San Francisco School of Medicine CA - Stanford University School of Medicine CA - Touro University, California - College of Osteopathic Medicine CA - Western University of Health Sciences College of Osteopathic Medicine of the Pacific CO - University of Colorado Health Sciences Center School of Medicine CT - University of Connecticut School of Medicine CT - Yale University School of Medicine DC - Georgetown University School of Medicine DC - George Washington University School of Medicine DC - Howard University College of Medicine FL - University of Florida College of Medicine FL - University of Miami Leonard M. Miller School of Medicine FL - Florida State U College of Medicine FL - University of South Florida College of Medicine FL - Lake Erie College of Osteopathic Medicine-FL FL - Nova Southeastern University College of Osteopathic Medicine GA - Emory University School of Medicine GA - Medical College of Georgia School of Medicine GA - Mercer University School of Medicine GA - Morehouse School of Medicine HI - University of Hawaii John A. Burns School of Medicine IA - University of Iowa Roy J. and Lucille A. Carver College of Medicine IA - Des Moines University College of Osteopathic Medicine IL - Chicago Medical School at Rosalind Franklin Univer IL - Loyola University Chicago Stritch School of Medicine IL - Rush Medical College of Rush University Medical Center IL - University of Illinois College of Medicine IL - Northwestern University The Feinberg School of Medicine IL - University of Chicago Pritzker School of Medicine IL - Southern Illinois University School of Medicine IL - Chicago College of Osteopathic Medicine of Midwestern University IN - Indiana University School of Medicine KS - University of Kansas School of Medicine KY - University of Louisville School of Medicine KY - University of Kentucky College of Medicine KY - Pikeville College School of Osteopathic Medicine LA - Tulane University School of Medicine LA - Louisiana State University School of Medicine in New Orleans LA - Louisiana State University School of Medicine in Shreveport MA - University of Massachusetts Medical School MA - Tufts University School of Medicine MA - Harvard Medical School MA - Boston University School of Medicine MD - University of Maryland School of Medicine MD - Johns Hopkins University School of Medicine MD - Uniformed Services U of the Health Sci F Edward Hebert SOM ME - University of New England College of Osteopathic Medicine MI - Wayne State University School of Medicine MI - Michigan State University College of Human Medicine MI - University of Michigan Medical School MI - Michigan State University College of Osteopathic Medicine MN - University of Minnesota Medical School MN - Mayo Medical School MO - Saint Louis University School of Medicine MO - Washington University in St. Louis School of Medicine MO - University of Missouri-Columbia School of Medicine MO - University of Missouri-Kansas City School of Medicine MO - A.T. Still University of Health Sciences Kirksville College of Osteopathic Medicine MO - Kansas City University of Medicine and Biosciences College of Osteopathic Medicine MS - University of Mississippi School of Medicine NC - Wake Forest University School of Medicine NC - University of North Carolina at Chapel Hill School of Medicine NC - Duke University School of Medicine NC - The Brody School of Medicine at East Carolina University ND - University of North Dakota School of Medicine and Health Sciences NE - Creighton University School of Medicine NE - University of Nebraska College of Medicine NH - Dartmouth Medical School NJ - UMDNJ--New Jersey Medical School NJ - UMDNJ-Robert Wood Johnson Medical School NJ - UMDNJ--School of Osteopathic Medicine NM - University of New Mexico School of Medicine NV - University of Nevada School of Medicine NV - Touro University, Nevada - College of Osteopathic Medicine NY - New York University School of Medicine NY - Weill Medical College of Cornell University NY - Columbia University College of Physicians and Surg NY - Albert Einstein College of Medicine NY - New York Medical College NY - SUNY Downstate Medical Center College of Medicine NY - Albany Medical College NY - SUNY Upstate Medical University NY - University at Buffalo State University of New York School of Medicine NY - University of Rochester School of Medicine and Dentistry NY - Mount Sinai School of Medicine of New York University NY - Stony Brook University Health Sciences Center School of Medicine NY - New York College of Osteopathic Medicine Of The New York Institute of Technology OH - Medical University of Ohio at Toledo OH - Ohio State University College of Medicine and Public Health OH - Case Western Reserve University School of Medicine OH - Northeastern Ohio Universities College of Medicine OH - University of Cincinnati College of Medicine OH - Wright State University Boonshoft School of Medicine OH - Ohio University College of Osteopathic Medicine OK - The University of Oklahoma College of Medicine OK - Oklahoma State University Center for Health Sciences College of Osteopathic Medicine OR - Oregon Health & Science University School of Medicine PA - University of Pittsburgh School of Medicine PA - Pennsylvania State University College of Medicine PA - Drexel University College of Medicine PA - Temple University School of Medicine PA - University of Pennsylvania School of Medicine PA - Jefferson Medical College PA - Lake Erie College of Osteopathic Medicine-PA PA - Philadelphia College of Osteopathic Medicine RI - Brown Medical School SC - University of South Carolina School of Medicine SC - Medical University of South Carolina College of Medicine SD - University of South Dakota School of Medicine TN - Meharry Medical College TN - Vanderbilt University School of Medicine TN - East Tennessee State University College of Medicin TN - University of Tennessee Health Science Center College of Medicine TX - University of Texas Southwestern Medical Center at Dallas TX - Baylor College of Medicine TX - University of Texas Medical School at Houston TX - University of Texas Medical Branch at Galveston TX - Texas Tech University Health Sciences Center School of Medicine TX - The Texas A & M University System Health Science Center College of Med TX - University of Texas Medical School at San Antonio TX - University of North Texas Health Science Center at Fort Worth Texas College of Osteopathic UT - University of Utah School of Medicine VA - University of Virginia School of Medicine VA - Eastern Virginia Medical School VA - Virginia Commonwealth University School of Medicine VA - Edward Via Virginia College of Osteopathic Medicine VT - University of Vermont College of Medicine WA - University of Washington School of Medicine WI - Medical College of Wisconsin WI - University of Wisconsin Medical School WV - Edwards School of Medicine at Marshall University WV - West Virginia University School of Medicine WV - West Virginia School of Osteopathic Medicine School Other Degree Doctor of Medicine Doctor of Osteopathy Doctor of Philosophy Master's Degree Bachelor's Degree Other MD/PhD Graduation Year* 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990     OTHER   I'm currently a Chapter Officer/Advisor at my school Officer Title President Vice President Treasurer Social Officer Secretary Advisor Other   If Other, Please Specify I am a NEW chapter president, please update our chapter's information. I'd like information on how to start a chapter at my school!