FREDERICK A. COLLER SURGICAL SOCIETY

APPLICATION FOR ASSOCIATE MEMBERSHIP

 

Associate membership is for resident physicians seeking membership with the Coller Surgical Society. Associate members may attend the annual meeting, but will not pay dues. For full eligibility and criteria, please see the Constitution and Bylaws.

TO THE COUNCIL OF THE FREDERICK A. COLLER SURGICAL SOCIETY

I hereby make Application for Associate Membership in the Frederick A. Coller Surgical Society.


I SUBMIT THE FOLLOWING DATA CONCERNING MY MEDICAL EDUCATION AND SURGICAL TRAINING


Premedical education

Medical education

Training following Internship

Association with a Member of this Society?