Membership Application Name: ________________________________ Address (and Apt. #): ____________________ _____________________________________ City/State: _____________________________ Zip Code: _____________________________ Phone: _______________________________ Email: ________________________________ Gender:
Anticipated Graduation Year: ______________ T-Shirt Size: S
_____ I grant AMSA permission to use photos of me for AMSA events/materials.
CSUSB Chapter Membership (Mandatory) Please check the amount enclosed with your application ___ $15 New Members ___ $10 Returning Members Please place application and dues in sealed envelope and drop off at SLD office (Student Union room 203) 8am - 5pm Monday - Friday. Clearly label envelope “AMSA mailbox #22”. Please make checks payable to AMSA. Thank you for your application!
2010 - 2011 Officers President Virginia Tancioco firstname.lastname@example.org Vice President Diana Romo email@example.com
American Medical Student Association
CSUSB Pre-Medical Chapter
Secretary Binh Pham firstname.lastname@example.org Treasurer Charlene Rodríguez email@example.com Webmaster Pauline See firstname.lastname@example.org Service Coordinator Tafadzwa Dzimri email@example.com Recruitment Coordinator Ricardo Juárez firstname.lastname@example.org Social Coordinator Sepideh Homayoni email@example.com Fundraising Coordinator Karen Ek firstname.lastname@example.org
amsacsusb.org Visit us on Facebook www.facebook.com/amsacsusb
AMSA CSUSB Chapter
AMSA is the largest pre-medical organization in the country. Our aim is to provide a community of support for students interested in the medical field. AMSA is a great way to gain community service experience, clinical experience, leadership skills, and effective networking with other students to get help with the MCATS and exchange study materials. All AMSA members will have access to all AMSA records and references when applying to medical school, participate in the new Community Service Program started with the Dean of Natural Science, and much more. All activities and events in AMSA are aimed at strengthening your application to medical school.
All AMSA members will be automatically enrolled in the Community Service Program aimed to promote community service to the local community. Students participating in the program will receive recognition for exemplary community service upon completion of 200 community service hours. The Certificate of Excellence will be recognized and endorsed by Dr. Robert Carlson, the Dean of Natural Science, Dr. Stuart Sumida, Head of the Articulation Program to Western University Medical School, and Dr. David Polcyn, the Biology Department Chair. Students are to log their community service days and hours. Once 200 hours are completed, the logs are to be given to the AMSA president or vice president for verification. Certificates will be issued after verification.
The American Medical Student Association (AMSA), with a half-century history of medical student activism, is the oldest and largest independent association of physicians-in-training in the United States. Today, AMSA is a student-governed, national organization committed to representing the concerns of physiciansin-training. AMSA members are medical students, premedical students, interns, residents and practicing physicians. Founded in 1950, AMSA continues its commitment to improving medical training and the nation's health. How is AMSA different from other organizations? When you join AMSA, you become part of a vital force of future physicians who believe that patients and health professionals are partners in the management of health care and that access to high-quality health care is a right and not a privilege. At AMSA, activism is a way of life. Student idealism is transformed into meaningful public service, innovation and institutional change.