PhiDE Individual Membership Application

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

What year did you graduate college/university? *

What premedical chapter did you join? (if applicable)

What medical school do you currently attend? *

What is your anticipated date of medical school graduation? *

Please share why you wish to join our Fraternity as a medical student. *

What attributes make you worthy of membership in Phi Delta Epsilon? *

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Upon receipt and approval by the Executive Office, you will be sent an electronic invoice for lifetime dues of $250 plus a $5 online fee. New members receive a new member packet which includes: the 2022 USMLE First Aid, MDPocket, silver lapel pin (gold for past premedical members) and gold medical student badge.

+Past premedical members who graduated from their chapter in good standing are automatically granted membership if joining in the first year of medical school. If you have not been a member of Phi Delta Epsilon, the Executive Office will review your application before granting membership of any kind.