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SPA Membership Renewal Application Form


Use this form for annual dues renewal. Mail completed form and dues payment
(payable to Southern Psychiatric Association) to:

Susan Proctor
Executive Director
Southern Psychiatric Association
6501 N. Charles Street
Baltimore, Maryland 21204

Annual dues for the calendar year are due by January 31st of each year.

Dues (Annual)
SPA Membership
               $200
    $25
               $110

Southern Psychiatric Association
6501 N. Charles Street
Baltimore, MD 21204
410-938-3403
info@sheppardpratt.org

Web Site Maintained by Sheppard Pratt Health System www.Sheppardpratt.org