The Hillsborough County Medical Association Alliance is a service organization comprised of spouses of physicians who practices and resides in Hillsborough County. We are dedicated to projects that promotes good health and health education, and to develop and enhance opportunities where physicians and medical families can contribute to Hillsborough County and protect welfare of the medical community.
Dues For Membership
2010
| Regular Dues (HCMA Alliance & FMA Alliance) | $75.00 |
| Medical Student/Intern/Resident | $30.00 |
| Retired/Widowed | $25.00 |
| AMA Alliance (Optional) | $50.00 |
| Download the Membership Form (Word Doc) | |
| Make check to: | HCMA Alliance |
| Send to: | HCMA AllianceMembership 606 S. Boulevard Tampa, FL 33606 |
Name _____________________________ Spouse's Name ______________________________
Address ________________________________________________________________
_______________________________________________________________________
Phone _____________________ Cell Number _____________________
E-mail Address _____________________________________________
Dues must be received no later than March 1st to appear in the 2010 Membership Directory which will be available in our Web site after April 1st, 2010.
This year I would like to attend programs/ and or support the following activities:
(Please mark as many as apply)
| □ Holiday Sharing | □ Go Red for Women Lunch |
| □ Doctor’s Day | □ Community Outreach/Fundraising |
| □ Screen-Out Activities | □ Legislative Briefings |
| □ Wine Tasting | □ Financial Planning |
| □ Evelyn Shaver Scholarship | □ Other________________ |
Do you have any other suggestions for the Alliance?
____________________________________________________
____________________________________________________
Would you like to host one of our activities at your home?
____________________________________________________