AAFCP Student Member Application

Student Member

* must be filled in.

*Name
(First Initial Last) As you would prefer it to appear officially.
*Address
*City
*State / Prov
*Country
*Zip / Postal Code
*Home Phone:
Office Phone:
*Mobile Phone:
*Fax:
*Email:
*Confirm Email:
FCP Program
Address:
Program Director:
Program Supervisor:
Date of Enrollment:
Anticipated Date of Completion:
Completion Date:
Student membership may be maintained while you are in an Academy Approved Education Program.
A letter of recommendation from your Education Program Director or Supervisor is required. A recommendation has been requested from:
 
MEMBERSHIP DUES:

There is no fee for the first year of Student Membership. Then Annual Membership dues will be $25.00.

August 1st. is the annual renewal date for all membership dues. If your application is approved within three months prior to the renewal date, your membership dues will be considered paid for the upcoming year. If your application is approved within the membership year (August-May), the dues will be for the current year. This determination is based on Board of Directors approval, not on the application date.

Membership Referral
I was encouraged to seek Academy membership by:

 
CODE OF ETHICS:

I have read and agree to accept and adhere to the principles and standards of conduct defined in the Code of Ethics of the American Academy of FertilityCare Professionals.
   
 
* Once you have completed the above information, please click submit. You will be contacted by the AAFCP Board of Directors.