2017 Dues Payment

Name
Practice
Work Address
City
State
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Office Phone
FAX
Email
Home Address
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Please choose which membership you are paying for:
 

MCMS Active Member Dues:  $300.00
MCMS New Member Dues (Mid-Year): $150.00
Dual Membership for MCMS and Metrolina Association of Physician Assistants (MAPA): $90.00
MCMS Physician Assistant Member Dues:   $105.00
MCMS Emeritus–Early Retired Membership $150

Member Services will commence upon receipt of your dues
 
Sustaining Membership
I would like to make an extra contribution of $25.00 to support the Medical Society
Amount paying: $