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INSTRUCTIONS
- Please fill out this form completely.
- You will need to send a copy of your board certificate to the office of the secretary.
- Two active members of Midwest Surgical Association must provide letters of recommendation on your behalf. They will send the letters directly to the office of the secretary.
- To acknowledge that you agree to honor the pledge of the Association, be sure to type your name and the date in the boxes provided at the end of this form.
- Deadline: To be considered for membership in the current year, your completed application packet must be in the office of the secretary by the last week of July. The application will be presented to the Executive Council meeting in August.
US mail submission:
Roxie M. Albrecht, MD
Secretary, Midwest Surgical Association
Oklahoma University Health Sciences Center
920 Stanton L. Young Blvd WP 2140
Oklahoma City, OK 73104 |
Facsimile submission: (405) 271-3919
For more information contact: Linda-Gentry@ouhsc.edu
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