Association of Professional Standardized Patients International (APSPI) - Application

- Basic Membership

$50.00/year
Free Dues Through July 2008
Open to Standardized Patients with less than 2 years of experience.

- Professional Membership

$60.00/year
Free Dues Through July 2008
Open to Standardized Patients with 2 or more years experience.

APSPI Membership - Free Dues Through July 2008

Name: * Required Field

Address: * Required Field

City: * Required Field

State: * Required Field

Zip: * Required Field

Phone Number: * Required Field

Email Address:

Membership Type?
Basic (2 years/less experience) - $50.00/year Free Dues Through July 2008
Professional (over 2 years experience) - $60.00/year Free Dues Through July 2008

Your experience as a standardized patient:

Include all types of cases portrayed:

Are you a GTA/UTA ?

Are you a Standardized Patient Teaching Assistant and what type of exams do you teach?

Do you have any medical training?

Other Comments: