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Application


To apply for membership, fill out the following form completely. If you would prefer, you can download a printable PDF application to fill out and mail or fax it to us.

Required fields are marked with an asterisk (*).

Step 1 Fill out application
Step 2 Pay online with credit card or Paypal

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 I'm applying for a new membership
I'm renewing my current membership

Your first name:* A value is required.      
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Mailing address:* A value is required. City:* A value is required.
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Membership type*
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Please select the membership type you are applying for.
Fellow
Fellow members are defined as Physician Assistants who are licensed in and residents of Alaska, and who are Fellow members of the AAPA. A fellow member can vote and hold an AKAPA office.
One year $100.00 Three years $270.00
Associate
Associate members are Physician Assistants or health care professionals who do not meet the criteria for AKAPA Fellow Membership.
One year $100.00 Three years $270.00
Student
Student members must currently be enrolled in an accredited PA training program, and must be from, reside or intend tor eside in the State of Alaska following graduation.
No cost

Three year membership reflects a 10% discount. Membership is based on a calendar year from January to December.


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Note: AKAPA members whose collaborative physician is a member of ASMA may also join ASMA!  An ASMA membership form can be downloaded by clicking here.
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