RISE HEALTHCARE SOCIETY

Membership Application

Thank you for your interest in RISE Healthcare Society.

RISE is a distinguished professional community created for minority women who are leading, building, influencing, and advancing healthcare.

Applications are individually reviewed for professional eligibility and alignment with the mission, values, and community of RISE.

Do not fill this out if you are human:

01 About You

First Name Last Name Email Address Mobile Phone Number City & State LinkedIn Profile Optional

02 Minority Representation

How do you identify? Select all that apply.

Prefer to self-describe

RISE invites applicants to self-identify. Please select at least one option above or use the self-description field.

03 Your Healthcare Career

Current Professional Title Organization, Company, Practice, or Healthcare Organization Which category best describes your current professional role?How many years have you worked in healthcare?Briefly tell us about your current role and your work within healthcare.

04 Your RISE ConnectionWhy are you interested in becoming a member of RISE Healthcare Society?

What do you hope to gain from your RISE membership? Select all that apply.

RISE is built not only around what members receive, but also around what each woman brings to the community. What experience, expertise, perspective, relationships, or strengths would you bring to RISE?

05 Community & Referral

How did you hear about RISE Healthcare Society?Were you referred by a current RISE member?If yes, who referred you?

06 Membership CommitmentRISE is an active professional community. Are you interested in participating in RISE experiences, including networking, professional development, community impact initiatives, and opportunities to support fellow members?

I understand that RISE Healthcare Society membership is application-based and that submitting an application does not guarantee acceptance.I understand that annual membership dues are $900, with payment options available upon acceptance.If accepted, I agree to uphold the values of professional respect, sisterhood, inclusion, integrity, and meaningful community engagement within RISE Healthcare Society.

07 Final QuestionIs there anything else you would like the RISE leadership team to know as we consider your application?Optional

ANNUAL MEMBERSHIP: $900

No payment is required to submit an application. Membership dues are collected only upon acceptance.

By submitting this application, you are requesting consideration for membership in RISE Healthcare Society. Your responses will be reviewed by RISE leadership.