Join Us For An Exciting Year

JEFFERSON PARISH
MEDICAL SOCIETY ALLIANCE

2008 MEMBERSHIP DUES ARE DUE

ANNUAL FEDERATED MEMBERSHIP......$75 ($15 Parish, $35 State, & $25 AMA)
make your check payable to J.P.M.S.A. at
7937 Oak Street
New Orleans, LA 70118

Name:
Address:
City, ST Zip:
Email:
Day Phone:
Evening Phone:
Fax:
Check #: