Welcome to PHSAPA Public Health Service Academy of Physician
Assistants
U.S. Public Health Service
Membership
PHSAPA Coin
Send mail to webdesign@phsapa.com with questions or comments about this web site. Webpage creation and design by LT Rodney
Shane Sluss Copyright © 2008 Public Health Service Academy of Physician Assistants Last modified:05/11/2010
PHSAPA
Today's Date:
Full Name:
Rank:
Address:
Email:
H-Phone:
C-Phone:
W-Phone:
Branch of Service:
Agency (exp. BOP/IHS):
AAPA #:
NCCPA #:
Civil Service/GS Rating:
Active Duty/Retired:
Membership - $ 45.00 (please submit your payments for the July 1st 2010 – June 30th, 2011 fiscal
year between April through June 30th 2010, thank you)
Student Membership - Exempt
Check #:
If using the online form don't forget the check number.
Membership
Credit Card or PayPal Here
Three options:
1) Pay with credit card or Paypal and in Paypal enter info in "Add special instructions to
the seller" as in online form below: Students are Free, just fill out online form below
2) Fill out the Online membership form.  After hitting submit, print a copy of the page
you see and send that along with the Check to the address below.
3) Click the download-able version and fill it out by typing in it or print it out and enter
info and send the Check to the address below.
Downloadable version of MembershipForm (will open a new page)
Please make your membership check payable to: PHSAPA Membership
Attn: LCDR Philip Lafleur
20 Reardon Rd.
Billerica, MA 01821
Click here for the text version in Black an White. This will take you to another page or document for better accessibility.  A link will be provided in the black and white
text version as well to come back here.