PMSA Annual Membership Form

Annual Membership Application & Renewal

Membership enrollment opens annually by decision of the Local SecGen to review eligibility and process statutory membership dues.

Select Your Local Committee:

Official Membership Form - PMSA-Nablus

Officially Open by Local SecGen

Official Dues New: 30 ILS | Renewal: 20 ILS

Application Type & Dues *

New Member (30 ILS) Membership Renewal (20 ILS)

Payment is audited by Local Treasurer. Failure to pay leads to suspension.

Full Name (Arabic) *

Full Name (English) *

Medical School Student ID *

National ID / Passport *

Email Address *

Phone / WhatsApp *

Current Academic Year *

Standing Committee Interest

Motivation / Previous Experience