Application to join the Women's Dermatologic Society

Membership Costs:
$25 for the application fee and $100 for the annual dues for a total of US $125.00.
The application fee and dues are waived for those applying for Resident Member status

For the first year post-residency and International E-Member (NEW) $25 for the application fee and $50 for the annual dues. If it has been one year or less since you completed residency training, please submit a total of US $75.00.
The application fee and dues are waived for those applying for Graduate Member Status.

Application must be accompanied by a non-refundable application fee and first year’s annual dues. (Dues will be refunded if membership is not granted).

Categories of Membership (CHOOSE ONE):

Active Member

Any physician who is a resident of the United States of America or Canada and who has been certified by the American Board of Dermatology, received specialty certification in dermatology by the Royal College of Physicians and Surgeons of Canada, or is certified by the American Osteopathic Board of Dermatology shall be eligible to be an Active Member. Active members shall have full membership rights as recognized under customary parliamentary practice, including, but not by way of limitation, the rights to attend membership meetings, to participate in discussion, to vote, to be a candidate for elective office and to accept appointment to committees and councils. Active members shall be obligated to pay all dues and assessments imposed on Active Members under Article X of these Bylaws and shall be obligated to observe all Bylaws and administrative regulations of the Society.
Membership Dues for Regular Active Members = $100

Associate Member

Any physician of good standing who is a resident of the United States of America or Canada, who has had three years of full time experience in the practice of or is a teacher or graduate student of dermatology and who has had training which qualifies the person for the examination of the American Board of Dermatology, the examination in dermatology of the Royal College of Physicians and Surgeons of Canada, or eligible for the examination of the American Osteopathic Board of Dermatology shall be eligible to be an Associate. Associates shall have all of the rights of active members except that they shall not be eligible to serve in any elective office. Associates shall be obligated to pay all dues and assessments imposed upon Associates under Article X in these Bylaws and shall be obligated to observe all Bylaws and administrative regulations of the Society.
Membership Dues for Associate Members = $100

Resident/Fellow
Member

Any physician who is currently participating in a training program in dermatology which is accredited by the Accreditation Council of Graduate Medical Education, and is actively pursuing the educational requirements for certification by the American Board of Dermatology or for certification in dermatology the Royal College of Physicians and Surgeons of Canada shall be eligible to be a Resident/Fellow Member. Resident Osteopathic Dermatologists who are board-eligible or board-certified by the American Osteopathic Board of Dermatology and Osteopathic Dermatology Residents in American Osteopathic Association-approved dermatology training programs shall be eligible for the Resident/Fellow member category. Resident/Fellow members shall have all of the rights of active members except the right to hold elected office or the right to vote in elections provided, however, that when appointed to any commission, council, committee or task force, Resident/Fellow members may vote on matters before that group. Resident/Fellow members shall not be required to pay dues or assessments but shall be required to pay registration fees and fees for social events.
Membership Dues for Resident/Fellow Member = Complimentary
Membership Dues for 1st Year Post-Residents = $50

Life Member

An Active Member in good standing, who by reason of physical infirmity or retirement from practice, at any age, shall be made a Life Member upon written request to the Secretary and approval by the Board of Directors. A Life Member shall continue to enjoy all the membership rights of her/his prior membership category in the Society. She/he shall not be required to pay dues or assessments but she/he shall be required to pay registration fees and fees for social events as do all members.
Membership Dues for Life Member = Complimentary

Honorary Member

An Honorary Member shall be a woman or a man of outstanding attainment recommended to the Board of Directors and elected by 2/3 vote of the Board of Directors. She or he shall enjoy all the rights and privileges of membership. He or she shall not pay dues or any other assessments, but shall be required to pay registration fees and fees for social events.
Membership Dues for Honorary Member = Complimentary

Corporate Member

A corporate member shall be a woman or man currently employed or engaged in a business activity that supports the specialty of dermatology. These members shall be non-dermatologist physicians, PhD holders or other scientists devoting a major portion of their time to dermatologic research in industry settings, or non-scientist industry leaders on a director level or higher whose careers are devoted to promoting the field of dermatology or improving dermatologic care.
She or he shall enjoy all the rights and privileges of membership except the right to vote or hold an elective office. Corporate members, when appointed to any commission council, committee or task force, may vote on matters before that group. He or she will pay dues, registration fees, social events fees, and any other appropriate assessments.
All applications for corporate membership shall be evaluated by the Committee on Membership and voted on by the Board of Directors. Applications for corporate membership shall have two letters of recommendation from WDS leadership. WDS reserves the privilege to limit the number of corporate members from a given company. If a corporate member leaves the company under which their membership was approved, they must notify WDS. WDS reserves the privilege to terminate corporate membership if a corporate member leaves the company under which their membership was approved.
Membership Dues for Corporate Member = $100

Affiliate/International
Member

Physicians who are certified in dermatology by a non-US or non-Canadian board or its licensing equivalent or who satisfy educational or professional requirements approximately equivalent to the requirements for certification by the American Board of Dermatology or the requirements for certification in dermatology by the Royal College of Physicians and Surgeons of Canada; Physicians who do not reside in the US or Canada who are certified by either the American Board of Dermatology or Royal College of Physicians and Surgeons in Canada; Practicing dermatopathologists who are not eligible to be Active or Associate members of the Women's Dermatologic Society; Non-dermatologists physicians, Ph.D. degree holders and other scientists devoting a major portion of their time to dermatologic research and/or education in academic medical centers, or teaching hospitals; Veterinarians specializing in veterinary dermatology; Dentists holding the D.D.S. or D.M.D. degree with special interests in oral/cutaneous medicine.
Membership Dues for Affiliate/International Member = $100

International e‐Member
• NEW •

International Resident e‐Member
• NEW •

Joint WDS/EuWDS
International Membership
• NEW •
(Clicking button will send you to a new page & simplified application)

Membership is open to dermatologist who reside outside the U.S. or Canada and who are certified in dermatology by a non-US or non-Canadian board or its licensing equivalent or who satisfy education or professional requirements approximately equivalent to the requirements for certification by the American Board of Dermatology or the requirements for certification in dermatology by the Royal College of Physicians and Surgeons of Canada. Joint WDS/EuWDS International Members are eligible to serve on WDS committees, be mentors, submit articles, and be considered for scientific events. These members may vote, but are not eligible to hold office. They will receive all materials produced for members by WDS and EuWDS and are obligated to pay all dues and assessments imposed by the WDS and EuWDS bylaws and to observe all bylaws and administrative regulations of the Women's Dermatologic Society and the European Women's Dermatologic Society.
Membership Dues for Joint WDS/EuWDS International Membership = $100

Application Date:

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APPLICANT INFORMATION: (Peer Apprentice)

Full Name:

Birthdate:

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Degree or Title:

Spouse Name:

Preferred Mailing Address:

Address:

City:

State:

Zip:

Country

Office Telephone Number:


City/Area Code	Local Number	Country Code

Fax Number:


City/Area Code	Local Number	Country Code

Citizenship:

Practice:

Private
Academic
Other

EDUCATION INFORMATION:

Undergraduate Institution:

Institution:

Location:

Year Completed

Degree

Medical or Graduate School:

Institution:

Location:

Year Completed

Degree

Residency (Postgraduate Training):

Institution:

Location:

Specialty:

Year Completed
Proposed Completion

Degree

Other Specialty Training:

Institution:

Location:

Year Completed
Proposed Completion

Degree
or Title

Areas of Specialization:

CERTIFICATION:

American Board of Dermatology:
Board Eligible	Board Certified

Royal College of Physicians and Surgeons of Canada
Board Eligible	Board Certified

Equivalent Board (other countries)
Board Eligible	Board Certified

Other Specialty Boards
Board Eligible	Board Certified

Other Specialty Boards
Board Eligible	Board Certified

Other Specialty Boards
Board Eligible	Board Certified

ADDITIONAL INFORMATION:

List names of at least two members of the Women’s Dermatologic Society from whom the Committee may request letters of endorsement. One of these members should reside in the vicinity of the applicant. (Contact WDS headquarters if sponsors are needed). PLEASE NOTE FOR RESIDENT APPLICANTS ONLY:* The requirement for two letters of recommendation is waived for resident applicants only. Instead, please provide your residency program director's name and phone number.
Member Name 1:	*() Required to process application**
Member Name 2:	*() Required to process application**

Has your license to practice medicine in any jurisdiction ever been limited, suspended, or revoked?	Yes .... No
Have your privileges at any hospital ever been suspended, diminished, revoked or not renewed?	Yes .... No
Have you ever been denied membership or renewal thereof, or been subject to disciplinary action in any local, state, or national medical society?	Yes .... No
Have you ever been denied membership or renewal thereof, or been subject to disciplinary action in any medical society?	Yes .... No
Are there any charges pending resolution by a Board of Medical Examiners in any state in which you have practiced medicine?	Yes .... No
Have you ever been sanctioned by the Board of Medical Examiners?	Yes .... No

Additional Comments:

APPLICATION DETAILS:

*Incomplete applications will not be considered for membership.
Application must be accompanied by a non-refundable application fee and first year’s annual dues. (Dues will be refunded if membership is not granted).

Membership Costs:
$25 for the application fee and $100 for the annual dues for a total of US $125.00.
The application fee and dues are waived for those applying for Resident Member status

For the first year post-residency $25 for the application fee and $50 for the annual dues. If it has been one year or less since you completed residency training, please submit a total of US $75.00.
The application fee and dues are waived for those applying for Graduate Member Status.

METHOD OF PAYMENT:

Visa
MasterCard
American Express
Discover
Diner's Club

Click Submit Application Button Below and you will be taken to step 2 in the application process.

*Note: Use of the name of Women’s Dermatologic Society and/or the Society logo on business stationary or in any advertisement is prohibited.