Please mail your membership dues to AMPI address as soon as possible
MEBERSHIP CATEGORIES:
• $500 Life Membership • $750 Joint Life Membership
• $50 Annual Membership • $75 Joint Annual Membership
Dues Waived for the following categories:
Medical Student (Anticipated year of completion) _______
[ ] Resident or [ ] Fellow (Anticipated year of completion) ________ Specialty: _______________________________
AMPI Membership dues may be tax deductible as an ordinary business expense. Consult your tax advisor.
Pay by Check, Payable to AMPI
American Muslim Physicians of Indian Origin
810 73rd Street
Downers Grove, IL 60516 USA
Phone 630 852-0520