SCPM Membership Application
Dues are $75 annually for each location.
Membership dues are for one calendar year.
After completing this form, you may pay via credit card or check at an SCPM meeting.
If paying by check, please make payable to SCPM.
For more information or questions, please contact:
Seniorcareprofessionals@gmail.com
or contact a board member. Names and numbers are listed on Members page of the SCPM website.
Organization Name
Address
Address 2
City
State
Zip
Main Contact Person First Name
Last Name
Email
Phone Number
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