Membership

Join Today! Only $25 per year.

To pay with credit card:
First, fill in the Online Membership Form below and hit SUBMIT, then click the "Pay Now" button below to pay with your credit card. You will receive an email confirming your membership.

To pay with a check:
Click on Membership Form, type in the information and mail it with a check made out to The Wisconsin Sleep Society, PO Box 170692, Milwaukee, WI 53217.
Note: Your membership will not be activated until we receive payment. Please include your email on the form so we can send you confirmation that it was received.

If you have questions about using this form, please email mailto:info@wisleep.org or call Sue at 262.434.3450 for assistance.

Online Membership Application

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Applicant Information
Date:
First Name:
Last Name:
Address Street 1:
Address 2:
City:
Zip Code:
State (Must be WI):
Renewal	New Member
Certification Data
Check certifications that apply	ABMS-Sleep
	ABSM
	PsyD
	ABDSM
	BSM
	DDS
	RPSGT
Check membership you are applying for
Individual must possess MD, DO, PhD, DDS/DMD or other doctoral degree in sleep medicine.	Doctoral Membership
Individual whose primary employment is the sleep technology profession.	Polysomnographic Membership
Individual seeking a degree that leads to participation in sleep disorders medicine.	Student Membership
Individual with special training in the healthcare field such as nurses and sleep center managers who are practicing or interested in sleep medicine.	Affiliate Membership
Personal Phone:
Work Phone:
Email: *
Choose payment method	Pay with PayPal (Choose lin to Paypal above)
	Pay with check (Mail $25 to Wisconsin Sleep Society PO Box 170692, Milwaukee, WI 53217)
Note: WSS does not provide email addresses to third party organizations.	Email address requested for communication of WSS activities and business only.
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