American Academy of Family Physicians -- Strong Medicine for America
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Supporting (FP) Membership Application

 AAFP Membership Application  |  Name and Address Information
FirstMiddle(mm/dd/yyyy)State:Country:State:Students: Choose 'Home' above. Professional address is not required for students.Phone associated with preferred address is required.LastPrevious*Telephone:(if applicable)*= RequiredCity:*Home:* Name: Gender:Business:Country:Zip: Fax:*Home Address:*E-Mail:Member Type:Supporting (FP)Province:
Province:*Professional Address: Date of Birth:Zip:*Preferred mailing address:Source:City:

If applicant has never been an Active or Supporting FP member, or has not held Active or Supporting FP membership within the last two years, CME credits are not required. If the applicant has held Active or Supporting FP membership within the last two years, the applicant must provide evidence of 100 approved CME credits completed during the two years immediately preceding application. Please submit CME records to the AAFP Contact Center, 11400 Tomahawk Creek Pkwy, Leawood, KS 66211-2672. You can also fax your CME records to Attn: AAFP Contact Center, (913) 906-6075.