AAF Professional Membership Form

The Professional Memberships are for prosthetic facilities, individual prosthetists, prosthetic manufacturers, and other organizations.

Along with the basic Professional Membership, there is an opportunity to post an Internet link within your listing on our web site, annually charged in addition to the Professional membership dues.

To learn more about the membership benefits review our services.

Company Name:
Street Address:
City:
State:
ZIP Code:
Phone Number:
Fax Number:
Email:
Web Address:
Contact Name:
P.O. Number:
Please check one:
Membership	$150.00
Membership plus link	$250.00

Phone: (501) 835-9290
Email: info@americanamputee.org