MEMBERSHIP APPLICATION
Become a member in three easy steps…
2) Submit the application on line or print this completed application.
3) Mail a check payable to IMASC at the following address:
IMASC Membership Drive
P.O.Box 6765
Orange CA 92863
(You must enclose printed application if not submitted online)
Please note that IMASC is a nonprofit organization and the membership dues are fully tax deductible.
Our Non-Profit Tax Exempt ID is 330044199.
MEMBERSHIP DUES
1. Individual Life Membership: $1000
2. Joint Physician Couple Life Membership: $1500
3. Spouse Life Membership: $1500
4. Annual Membership: $125.
5.Medical Students, Residents and Fellows Membership: Free (with proof of ID)
|
