Membership - Student Application

We welcome new student members to join us as an integral part of the podiatric sports medicine community. Just complete the online form below to begin the member application process.

If you would like a membership application mailed to you, please request it either by telephone 301-370-2397 or email: ritayates2@aol.com.

* Required Fields

Name*:
Member Type:	Student Member ($10)
Mailing Address*:
City/State*:	State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY OTHER
Zip Code*:
Phone*:
E-Mail Address*:

Education

Podiatry School Attending*:
School City/State*:	State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY OTHER
Anticipated Degree*:
Anticipated Year of Graduation*:

Other College Experience

College City/State:	State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY OTHER
College Degree:
Year of Graduation:

APMA Membership (optional)

APMA Membership Number:

What is 8 + 2?"*: