AMSA MEMBERSHIP APPLICATION Spring 2016
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AMSA's Mission
The American Medical Student Association is committed to improving health care and healthcare delivery to all people; promoting active improvement in medical education; involving its members in the social, moral and ethical obligations of the profession of medicine; assisting in the improvement and understanding of world health problems; contributing to the welfare of medical students, premedical students, interns, residents and post-MD/DO trainees; and advancing the profession of medicine.
Deadline:
April 10, 2016 at 12pm

Last name, First name *
Student ID *
Email Address *
The best way to contact you.
Phone Number
Major
Academic Level:
Career Goal: *
Were you part of CSUN AMSA last semester? *
(Did you attend either an AMSA meeting or an AMSA event?)
Pertinent Medical Experience:
(i.e. medical experiences, certifications, licenses, volunteering history, employment)
What do you hope to gain by joining AMSA?: *
Would you like to be an AMSA officer for the 2016-2017 year? *
If yes, what position would you be interested in? (You may choose more than one response)
Required
National AMSA Membership Status* (Not Required):
Clear selection
National AMSA Membership Benefits:
*As an internationally recognized association, AMSA has an online membership which costs $75 for premedical students and includes many benefits, the membership is good for five years. The National AMSA Membership is not required by the CSUN AMSA Chapter, it is highly encouraged. Some activities may be limited to nationally registered members.  If you have any questions please feel free to contact us at amsa@my.csun.edu.
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