Honorary Membership

Annual Dues – $0

Honorary memberships are provided to those in volunteer leadership positions with FWGBD in recognition of their service. FWGBD Board Members, Medical Advisory Committee (MAC) members, LAN Chairs, and LAN Subcommittee Chairs are all eligible for these memberships. Registration is still required. (Please see below.)

To apply, please complete the membership application form below. Thank you for your support! 

Honorary Membership

Honorary Membership

Name
Name
First
Last
Degree/Credentials
Preferred Phone Type
Alternate Phone Type
Practice Specialty
Area of Practice
Mailing Address
Mailing Address
City
State/Province
Zip/Postal
Country
Current Institution Name and Address
Current Institution Name and Address
City
State/Province
Zip/Postal
Country
I am a current:

Questions? Contact Jennifer Longo at membership@fwgbd.org or 845.642.2925.