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I hereby make application for membership in the London and District Academy of Medicine and, promise to observe its rules and promote its interests. I also agree that I will not practise or profess to practise any system of medicine not approved by the College of Physicians & Surgeons of Ontario (CPSO), and that I shall adhere to recognized scientific medical practice. I further agree to accept, uphold and be governed by the by-laws of the Society in force at the time of my becoming a member, and by an amendments or additions that may thereafter be made to them; and shall further agree to abide by and accept the rulings and decisions of the properly constituted authority of the Society. I hereby apply to join the London and District Academy of Medicine and agree to be bound by its constituting agreement.
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