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  • National Center for LMSA Leadership & Advancement

    Member Registration for the 2022-23 Academic Year
  • Dear Current / Prospective Center Member,

    Thank you for your interest in the Latino Medical Student Association (LMSA) and our inaugural National Center for LMSA Leadershiip & Advancement. This initiative aims to provide physicians, faculty members, staff, and healthcare professionals with resources for their continual development as leaders in medicine. 

    Specifically, the National Center will focus on providing LMSA advisors and their colleagues with the knowledge and skills to:

    • Successfully address the academic, personal, and professional needs and pursuits of diverse trainees, particularly those involved with LMSA;
    • Enhance discussion of issues in Hispanic & Latina/o/x health at advisors’ respective institutions; and
    • Understand how to utilize their LMSA-related work for promotion purposes.

    We are proud to offer three National Center membership packages to academic medical centers - each with unique benefits - to help your institution meet your diversity and inclusion deliverables and achieve American Osteopathic Association (AOA), Liaison Committee on Medical Education (LCME), and Accreditation Council for Graduate Medical Education (ACGME) diversity standards. Benefits for each tier are depicted below and described further in this overview letter and on our webpage.

    Premier ($8,000) Elite ($5,000) Enhanced ($3,000)
    LMSA Chapter Advisor Orientation and Promising Practices Update (registration for 8 in person; 20 virtually) LMSA Chapter Advisor Orientation and Promising Practices Update (registration for 4 in person; 8 virtually) LMSA Chapter Advisor Orientation and Promising Practices Update (registration for 2 in person; 4 virtually)
    LIDEReS : LHS+ Identity, Development, Empowerment, and Resources Seminar (registration for 3 in person; 6 virtually) LIDEReS : LHS+ Identity, Development, Empowerment, and Resources Seminar (registration for 2 in person; 4 virutally) LIDEReS : LHS+ Identity, Development, Empowerment, and Resources Seminar (registration for 1 in person; 2 virtually)
    Hispanic Heritage Month Guest Speaker (1 hour presentation) + Community Conversation, and unlimited access to lectures Hispanic Heritage Month Guest Speaker (1 hour presentation) and access to 4 lectures Hispanic Heritage Month Guest Speaker (1 hour presentation) and access to 2 lectures
    Featured as Premier Institutional Member on LMSA National Webpage with institutional logo and school link Featured as Elite Institutional Member on LMSA National Webpage Featured as Enhanced Institutional Member on LMSA National Webpage
    E-Newsletter subscription and  full page ad quarterly E-Newsletter subscription and half page quarterly E- Newsletter subscription
    Academic Medicine Medical Spanish Fellow (1 person)    

    Please use this form to register for membership in the National Center for LMSA Leadership & Advancement for the 2022-23 academic year. Each membership term lasts THIRTEEN (13) months, extending from June 1, 2022 to June 30, 2023.

    This form is enabled to securely accept payment via credit/debit card for any membership tier. You may also use this form and submit payment via check. For check payments, please select the the desired payment method on Page 2, address all checks to "The Latino Medical Student Association" and mail to the address below:

    The Latino Medical Student Association
    1 East Erie Street
    Suite 525-4395
    Chicago, IL 60611

    A copy of the LMSA National W-9 Form is available here.

    For any questions regarding this form or the National Center, please reach out to center@lmsa.net. We look forward to welcoming you as a member of the National Center this year.

  • National Center for LMSA Leadership & Advancement

    New Member Registration Page 2 - Contact Information
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  • Wherever "Contact Person" is referenced, please provide information for the form respondent: the individual completing this form.

  • Each institutional member of the National Center is asked to name one representative from that institution to be its primary point of contact. This representative is referred to as the National Center Leader for your institution.

    This person is expected to attend monthly meetings with National Center leadership, provide feedback to LMSA on National Center activities, and respond to requests from LMSA regarding National Center initiatives.

  • On the next page, you will be asked to choose your institution's preferred membership tier and provide payment information.

  • National Center for LMSA Leadership & Advancement

    New Member Registration Page 3 - Tier Selection
  • National Center for LMSA Leadership & Advancement

    New Member Registration Page 4 - Payment Information
  • An invoice for 2022-23 National Center membership dues totaling ${membershipTier81} will be sent to the Payer specified below.

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  • By submitting this form, you confirm that you have:

    • Provided information in this form that is truthful, accurate, and complete;
    • Agreed to remit payment to LMSA in exchange for National Center membership benefits; and
    • Committed your institution to participate in National Center programming during the 2022-23 academic year to the fullest extent possible.

    Please hit "Submit" below to complete this registration form. If any questions or concerns arise, please contact center@lmsa.net. 

    NOTE: If the Submit button does not appear below, there is an error in your form responses above. Please ensure that the following questions are complete: method of payment, payer name, billing address.

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