Dues

Invoice

Download Membership Payment Form

Rapides Parish Medical Society Alliance

“Physicians’ Spouses Caring Today for a Healthier Tomorrow”

 

Name: ___________________________ Email: ________________________

MEMBERSHIP DUES (for May 1, 2014 – April 30, 2015)

Membership categories are described below:

Regular (Spouse of active Physician, part-time active or retired Physician)………………….$110

Over 60 (Regular members over 60 only pay local and state dues)…………………………………$60

Associate (Spouse of Medical Resident or Medical Student)…………………Dues Exempt

Honorary (Widow / Widower)…………………………………………………………..Dues Exempt

 

Donation to Hostess Fund………………………………………………………………………….$5

 

AMA- Foundation Holiday Sharing Card

Donations go to Louisiana Medical & Nursing Schools or the Medical School of your choice:_____________________________________________________________(list here)

You and your spouse will be listed on a Holiday e-card emailed to all Alliance / Medical Society Members in December.

Platinum Level Donation ($100 and over)     Silver Level Donation ($50-$74)

Gold Level Donation                 ($75-$99)               Bronze Level Donation ($25-$49)

 

Sharing Card Donation (Optional; Choose from levels listed above.)……$__________

TOTAL PAID…………………………………………………………….$__________

 

 

 

 

* Make checks payable to RPMSA and mail to:

Nenita Roy

4206 Willowick Blvd.

Alexandria, LA 71303

 

Thank YOU! Your membership makes a difference!