Member Volunteer Form
Please complete the following information and fax to AMSA c/o Greg Schaner at 202/833-4657 by Monday, April 19.
Yes, I would like to become a member of AMSA's Legislative Policy Committee.
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| Agency: | _____________________________________________________ |
| Address: | _____________________________________________________ _____________________________________________________ _____________________________________________________ |
| Phone/Fax: | _____________________________________________________ |
| E-Mail: | _____________________________________________________ |
| Special Interests: |
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