MACPhTS Membership Information
Yearly Membership is $15.00
Membership fee is due December of each year
To become a member, please print and complete the below information:
Mail Check made out to MACPHTS to the folowing address:
MACPHTS
C/o Shane Waldroup
8635 Valmont Circle
Cordova, TN 38016
Name: _______________________________________________
Street Address: ________________________________________
City_______________ State___________ Zip Code __________
Phone Number: ________________________
Email Address: ________________________
Current Employer: ______________________
How long have you been certified? ___________
How did you hear about MACPhTS? ____________