Resident Membership Application

Thank you for your interest in joining the Resident Membership platform at Expert Education Institute. Our Resident Members are a vital part of our mission to provide exceptional educational experiences and foster the development of future physicians. By joining, you will have access to exclusive events, resources, and mentorship opportunities that will enrich your professional journey.

Personal Information

Name with Credentials *

Preferred Name:

Gender (optional)MaleFemale

Contact Information

Email Address *

Phone Number *

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Educational Information

Medical School *

Year of Residency *

Academic & Professional Background

Current Residency Program *

Primary Interests or Areas of Focus in Medicine:

Academic Achievements/Notable Experiences

Membership & Participation

Why do you want to become a Resident Member of Expert Education Institute? *

How do you plan to contribute to the Resident Membership community? *

Mentor Triangle

Would you like to be enrolled in the Exed Mentor Triangle?YesNo

If yes, please briefly describe what you hope to achieve through mentorship:

Additional Information

Do you have any leadership experience that you would like to share?

Are you interested in volunteering for Expert Education Institute events or initiatives?Membership CommitteeUltrasoundFESTSocial Media CommitteeEducation CommitteeMentorship CommitteeOther

Terms and Agreement

Submission

Once completed, please submit your application to be considered for Resident Membership. Our team will review your application and contact you with next steps. Thank you for your dedication to advancing medical education and your interest in joining our community!

Currency

USD

Credit / Debit Card *

Expert Education Institute - Resident Membership Application