Graduate Medical Education

EmailEmail    |   Bookmark Page Bookmark  |   RSS Feeds RSS  |   Print Page Print  

Resident Spouse Association

About Us  Membership  Calendar  Milwaukee Info  FAQ

Membership Form

So glad you are considering joining the Resident Spouse Association!  As a member, you will be able to participate in all of our activities and build a network of friends and others who understand your situation.  Just fill out the following form, print it out and send via regular mail along with a dues payment of $30.  Make your check out to Resident Spouse Association.

Mail to: Meghan Burns, RSA Treasurer, 8525 W Hawthorne Ave, Wauwatosa, WI 53226.
Required fields are marked with an asterisk *.

Your Name

*First Name
*Last Name
Middle Initial

Spouse's Name & Specialty


Contact Information

*Street Address
Address (cont.)
*Zip/Postal Code
*Home Phone

Children's Names & Ages

Birth date
Birth date
Birth date

Questions, Concerns, Comments

If you have any questions, or encounter problems filling out this form, please email:
© 2014 Medical College of Wisconsin
Page Updated 06/17/2014