Sponsorship Application

Please complete the online form below or download the PDF application to apply:

Please fill out the application completely. After completing the form, you will 'Submit' for review.
Applicant's Name*
First Last
1. Applicant's Specialty (&S Sub-specialty)*
2. Applicant's Hospital Affiliation (to your knowledge)*
3. Applicant's Medical School Affiliation (to your knowledge)*
4. Will you personally vouch that the applicant’s character, morals and ability are of high quality so as to be an asset to the Greater St. Louis Obstetrical and Gynecological Society?*
- Yes
- No
5. Will you personally vouch that the applicant has not been and does not intend to be involved in any organization or activity conducted on principles or with goals contrary to the Principles of Medical Ethics of the AMA?*
- Yes
- No
Have you encouraged the applicant to actively participate in the activities and committees of the Greater St. Louis Obstetrical and Gynecological Society?*
- Yes
- No

Please fill out the application completely. After completing the form, you will 'Submit' for review.