Print this page
and send to the address below.
Name:______________________________
Address:_____________________________
Phone:______________________________
Facility:______________________________
Facility Address:_______________________
Facility Phone:________________________
Email:_______________________________
Position/Occupation:____________________
Date:________________________________
Individual Membership
Dues:
$30.00 annually
Make check payable to: ANMAP
Send your information and check/money to:
Shenna
Galla- ANMAP Treasurer
1313 Bellflower Drive
Rio Rancho, New Mexico 87144