WOCPRS MEMBERSHIP FORM
We invite you to participate in our Women of Color PRS (WOC-PRS) Society where we hope to create a forum for WOC to engage, connect, and empower each other through discussion and mentorship. Together, we can foster a conversation on important topics such as career advancement, work/family balance, financial planning, and more! We hope you will join the conversation.
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Given Name *
This refers to "First name"
Family Name *
This refers to "Last Name"
Occupation
(ie.Private Surgeon / MD, FACS |  Resident Physician / MD  |  Assistant Professor / MD, MBA)
Institution/Practice + Location
(ie. PGY-X Integrated at XYZ / Craniofacial Fellow at XYZ / Plastic Surgery Spa, Inc in New York City)
Race/Ethnicity
(ie. African-American/Black, Chinese/Taiwanese, Latinx/Puerto Rican, Nigerian, Prefer not to respond)
Email Address  *
Social Media Handle(s)
(ie. Twitter @, IG @, FB )
Comments/Questions
(ie. Activity recommendations, etc)
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