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Western Trauma Association (WTA) Membership Application









Active membership in the Western Trauma Association is open to Doctors of Medicine or Doctors of Osteopathy who are Board Certified in their particular medical specialty, as recognized by the American Board of Medical Specialties. Active membership is limited to 125 individuals. In keeping with the WTA’s effort to offer a multidisciplinary educational program, no more than 40% of the membership can represent any one specialty.

Associate membership is available to non-physicians with a special interest or expertise in trauma.

Before completing an application make sure you meet the following requirements:
  • I am a Board Certified MD/DO (Active Membership) OR a non-physician with a special interest or expertise in trauma (Associate Membership)
  • I have attended a Western Trauma Association meeting at least once in the past 3 years
  • I have been an author or co-author on a submitted scientific abstract for consideration by the WTA Program Committee in the past three years
  • I have a WTA Member willing to sponsor my application
  • I will attend at least 1 out of every 3 meetings prior to my becoming a member to remain on the membership wait-list

According to the WTA Bylaws:

Candidates for membership must submit a completed application and a letter of support from a sponsoring member of the Association. The candidate must also have been an author or co-author on a submitted scientific abstract for consideration by the Program Committee within three years of the time of the application and have attended a meeting within three years of the time of application.

Once the membership application is complete, the candidate will be considered a Member Initiate. A Member Initiate must attend at least one out of every three consecutive meetings prior to the meeting in which he/she is voted on for membership.

Membership Application
Applicant Information
This question requires a valid date format of MM/DD/YYYY.
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Office Address
Choose "Other" for locations outside of U.S. and Canada
This question requires a valid email address.
This question requires a valid email address.
1. Home Address
Choose "Other" for locations outside of U.S. and Canada
This question requires a valid email address.
2. Education
(Institution, Degree, Year)
(Institution, Degree, Year)
(Institution, Degree, Year)
3. Board Certification
4. Curriculum Vitae *This question is required.
The picture should be recognizable, but official 'suit and tie' pictures are discouraged
5. Photo
6. Western Trauma Sponsoring Member
A sponsor letter is required with your application. You have the option to email your sponsor letter to amy@westerntrauma.org or upload it with this application.
7. Sponsor Letter Submission *This question is required.
8. Upload Sponsor Letter *This question is required.
8. Western Trauma Association Meetings AttendedRequired for membership
9. Abstracts Submitted to Western Trauma Association - Most Recent Submission
10. Upload Most Recent Abstract *This question is required.
10. Abstracts Submitted to Western Trauma Association - Additional Submissions
11. Papers Presented at Western Trauma Association
This question requires a valid date format of MM/DD/YYYY.
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13. Submit *This question is required.
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Signature of