Name:
Hospital/Firm:
Position/Title:
Credentials/Certification:
Mailing Address:
City/St/Zip:
Office Ph:
Fax:
Home Ph:
E-mail:
Click on and fill out the Membership
Application and Join today.
Email or print NCAMSS Membership Application
Mail with your membership fee of $50 to:
Rhonda M. Boyd
Medical Staff Coordinator
Maria Parham Hospital
566 Ruin Creek Rd., Box 59
Henderson, NC 27536
P: 252-436-1563
boydr@mphosp.org
Please make check payable to
Rhonda Boyd, Treasurer, NCAMSS.
You may also pay membership fees at the
NCAMSS Home Page using PayPal
|
|
Indicate Type of Membership:
Active ($50) - Available
to persons involved in medical staff/credentialing activities. Eligible to
vote and hold office.
Associate ($50) -
Persons interested in the overall aims and objectives of the Association.
Not eligible to vote or hold office.
Honorary - Awarded
at discretion of the Board of Directors to those individuals who have
contributed to the advancement of the goals of the Association. Not
required to pay dues. Not eligible to vote or hold office.
Please indicate the committees on which you would like to serve:
|
