POWER IN NUMBERS, POWER THROUGH ALLIANCE, UNITED IN VISION™


New Membership Application - Join Online Today!

Name:
Credentials:
Address:
City:
State:
Zip:
Email Address:
Web Site:
Home Phone:
Cell Phone:
Office Phone:
Fax:
   
We would like to know a little bit about your practice. Please check below the procedures which you currently offer or plan to offer in your practice.
Sclerotherapy Chemical Peels Microdermabrasion
Mesotherapy Micropigmentation Laser/IPL Facial Rejuvenation
Vein Treatments  Other:
   
What topics or
issues are your
primary concern?
   
Membership Categories and Fees 2008 (US currency)
$125.00
Associate Members (MD, DO, Dentist, PA) $150.00
Affiliate Members (Medical Esthetician, Esthetician or other Paramedic $100.00
Sponsorship Members $200.00
Individuals and/or Industry who choose to become a sponsor member of AMEN play an important role by providing product information, equipment, equipment choices and technological advances, this allows us to keep members informed and connected with the latest information in the esthetic community.
   
Membership Dues

Membership dues are prorated depending on the Quarter in which a member joins. The table below outlines the payment schedule.

2008 Dues:
 Regular
Membership		 Associate
Membership
 Affiliate
Membership
 Sponsor
Membership
If Joining in 1st Qtr
(Jan, Feb, March)
 $125.00
 $150.00
 $100.00
 $200.00
If Joining in 2nd Qtr
(April, May, June)		 $100.00
 $125.00
 $75.00
 $175.00
If Joining in 3rd Qtr
(July, August, Sept.)		 $85.00
 $110.00
 $60.00
 $160.00
If Joining in 4th Qtr
(Oct, Nov, Dec)		 $65.00
 $85.00
 $50.00
 $100.00
 
 

Membership

 
 
1120 S. Federal Hwy. #4   Fort Lauderdale, Florida 33316    Phone: (954)463-5594    Fax: (954)463-4459

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