KMS Application Form

Please complete the Application Form below (or download the form and print) to become a member of the Kelowna Medical Society.

*Required fields are in bold text.

Full Name

Specialty

Office Address

City

Province
British Columbia

Postal Code

Contact Information

Office Phone

Office Fax (if available)

Email Address

 

Would you be interested in serving on the KMS Executive Committee?
yesno

Would you be interested in helping on KMS projects?
yesno

Any suggestions/ideas/comments?