GPSF Registration Form

Ghana Physicians and Surgeons Foundation

3650 Rogers Road #289 Wake Forest, NC 27587

info@ghanaphysicians.org

www.ghanaphysicians.org

+1 601-955-0903
Customer Details:
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail
example@example.com
Field or Specialty*
Eg: Cardiologist
GPSF Chapter*
Eg : Arizona
Suggestions if any for further improvement:
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GPSF Medical Students Membership
The student membership package offers online resources, webinars, workshops, and networking opportunities for aspiring doctors.

$ Free



GPSF Residents/Fellows Membership
Anyone who has completed medical school and is about to be in a training program or in a training program is considered a resident.

$50.00



GPSF Allied Professionals Membership
This allows our nurses, pharmacists, physical therapists and other allied professionals to become members of GPSF

$150.00



GPSF Regular Membership
This annual membership dues allows fully licensed doctors and dentists to be full time members.

$350.00



GPSF Lifetime Membership
This one time payment guarantees that you become a member for life. This allows the member to attend all annual meetings without paying annual fees.

$5,000.00



Total

$0.00
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