FAAPS Membership Application

Last Name: ________________________________________

First Name: ________________________________________

Present Address: __________________________________
__________________________________________________
__________________________________________________

Phone: ____________ Email Address: __________________

Year in School: (check one)
____Freshman ___Sophomore
____Junior ___Senior

Area of Interest: ___________________________________
(i.e., pre-medical, pre-health, dentistry, optometry, etc.)

Committee Interest:
___Fundraising ___Publicity
___Membership ___Programming
___Community Service

Membership dues are $15.00 per semester.

Mail Form and Payment to:

FAAPS
c/o Office of Pre-Professional Advising
USC 208 Sumwalt College
803-777-5581