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American Cleft Palate - Craniofacial Association
ACPA : Membership : Applications

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Membership Application

The application review process takes two to four weeks. You may prepay your membership dues with your application; or, following acceptance by the ACPA Membership Committee, you will be notified and billed for your dues and one-time entrance fee (if applicable).

2009 dues are:

Member Status Dues Entrance Fee 1st Year Total
Active $175 $25 $200
Associate $175 $25 $200
International** $210 (includes $35 airmail fee) $25 $235
International Student** $110 (includes $35 airmail fee) Waived $110
Student $75 Waived $75

If you are applying for Student or International Student Member status, you must be a full-time student or resident, and you need to obtain a letter from your department chair to verify your enrollment. In addition, please note that sponsor signatures are required on all but International and International Student applications. The National Office is happy to provide assistance to applicants seeking sponsors.

**International and International Student members may avoid the $35 airmail fee by electing to view the Journal and Newsletter online only (as opposed to receiving print editions).

If you have any questions, please contact Member Services Manager Rafael Goldberg at membership@acpa-cpf.org.

To download the PDF version of the membership application, click here. Applications must be filled out electronically (if you are only able to fill out by hand, please make it neat and legible) and may be submitted electronically, by fax or mail.

Please save a copy of your application for your files before sending it in.

All applicants must agree to abide by the ACPA Code of Ethics.

Thank you, we look forward to receiving your application!

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American Cleft Palate-Craniofacial Association

ACPA/CPF
1504 East Franklin Street, Suite 102
Chapel Hill, NC 27514-2820 USA
(919) 933-9044 , Fax: (919) 933-9604
info@acpa-cpf.org

© 2009 American Cleft Palate-Craniofacial Association

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 Cleft Palate Foundation

La Fundación del Paladar Hendido