AAPI Annual Membership Fee (AAPI Members ONLY - Check the appropriate box if you are paying Membership Fee )
Physicians in Practice(Couple):$100.00:
Spouse Name: ( Please Enter Spouse Name for Physicians Couple
Physicians in Practice(Single):$75.00:
Resident/Fellow in training (Couple):$50.00
Spouse Name: ( Please Enter Spouse Name for Resident/Fellow
Resident/Fellow in training (Single):$25.00
Total Amount *: $
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