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Registration
AAPPM Membership Application




Membership Dues – A Great Value
AAPPM dues are only $369 annual for APMA active members (those in practice more than four years), $169 for APMA Associate 1 through 4 (in practice four years or less) and APMA Senior Members, $139 for Executive Managers and Assistants – all great values! APMA residents and APMA students can join AAPPM at no charge, compliments of corporate educational sponsorship. To join AAPPM, doctors must be members in good standing with the American Podiatric Medical Association. All Residents & Students are welcome to join regardless of APMA membership.


Contact Information
Name Email
Credentials
Practice name/DPM name Address
City State Zip
Phone Fax



Practice Type





Podiatrist Group Number

Please note: All DPMs must currently be and remain members in good standing of the American Podiatric Medical Association to qualify for AAPPM membership. Assistant members must have a DPM in their practice who is an APMA member. Also note that membership fees are subject to change without notice.

How did you hear about AAPPM?


Membership Type







Please provide names of the 2 doctors who are already AAPPM members paying dues in the block below (mandatory).
   

Required Authorizations






Donation Amount (optional):


Total Amount Due:
Payment Information
Check #
(If unknown, please enter N/A to indicate payment by check)
US Funds Only.
Make payable to AAPPM and mail to : 1000 West St. Joseph Hwy, Ste 200 Lansing, MI 48915


Or


Credit Card #
Exp Date
Name on Card:
Billing Address
Billing City Billing State
Billing Zip Code

Please complete all fields before hitting submit. You will receive a confirmation when the registration is processed. Please give AAPPM a few days to process this registration and payment. If you do not receive a confirmation from AAPPM after 3 days, then your registration did not process correctly. Please contact the AAPPM office at 517.484.1930.