IAEAPE Membership Application

NOTE: Please list any updates for the Membership Directory on the IAEAPE Web site.

Please choose a suitable format below. Then, fill out the form and send it to:

IAEAPE
c/o Jonathon Novello

Michigan State University
330 Olin Health Center
East Lansing, MI 48824-1037
Phone: 517-355-4506
Fax: 517-432-0155
Email: Jonathon.Novello@ht.msu.edu

Please include a check for the membership dues

OR

Membership Prices

with PayPal/Credit Card

PayPal Instructions

Questions? Contact the Treasurer at Jonathon.Novello@hc.msu.edu

Application Forms

Download in Word (.doc) format | Download in Adobe .PDF format