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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? ____________

 





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