Individual Membership Application
MEMBERSHIP APPLICATION (Individual)
DUES BY MEMBERSHIP TYPE: See notes below) *
NOTES:
"Professional" is a medical professional and those like social workers, therapists, etc, directly involved in pediatric palliative care. )
"Associate" is a person interested or only indirectly involved in pediatric palliative care.
"Member Employee" is a person employed by a corporate member of the Coalition, 
"Parent" is a parent of a child in palliative care or who has been in palliative care. Benefits apply to both parents.
"Member Association" is an individual member belonging to a recognize medical professional association

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