To join The Pittsburgh Guild of the Catholic Medical Association, please:
1.) Print this page
2.) Complete this form
3.) Return completed form with Check payable for
the appropriate dues amount
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The Pittsburgh Guild of the CMA
2018-2019 Membership Form
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NAME_____________________________________________________________
E-MAIL____________________________________________________________
PHONE____________________________________________________________
SPECIALTY_________________________________________________________
___ Physician Member (Dues $50)
___ Non-Physician Associate (Dues $25)
___ Medical Student, Intern, Resident or Fellow (FREE!)
___ All Clergy, Religious and Seminarians (FREE!)
Please make checks payable to:
"The Pittsburgh Guild of the Catholic Medical Association"
Please return completed form to:
The Pittsburgh Guild of the CMA
c/o Deacon William Hahn, PhD
6435 Nicholson Street
Pittsburgh, PA 15217
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