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The International Medical Spa Association
520 23rd Street, Union City, New Jersey 07087 .:. phone: 201.865.2065 .:. fax: 201.865.3961 .:. email: medspaassn@aol.com

MEMBERSHIP APPLICATION

– HOW TO JOIN –
For your convenience we offer three easy ways to join.
 - Complete the application and click "Submit Application" to submit it electronically.
 - Complete the application, print and FAX to (201)865-3961
 - Complete the application, print it and mail with the appropriate membership fee, made payable to: 
 THE INTERNATIONAL MEDICAL SPA ASSOCIATION
 520 23RD STREET • UNION CITY, NJ 07087 
 Phone: 201/865-2065 • Fax: 201/865-3961
 Email: MedSpaAssn@aol.com
 www.medicalspaassociation.org
 

Your membership package, including current benefits, will be sent to you within 2-3 weeks.

 
  I want to be a Sustaining Member of the IMSA so I can help shape the future of the Medical Spa Industry.
I am willing to volunteer my time and be considered for a position on the Board.
I am enclosing my CV and a profile of my business and the organizations which I am affiliated with.
Annual fee $500.00                                                           Add'l person $75.00    2nd location $175.00
 
  I am joining as a business. I understand my membership is transferable to another person within my organization.
I am enclosing information on my business.
Membership fee $350.00                                                Add'l person $75.00    2nd location $175.00
 
  I am joining as an individual.
I understand that I am enclosing information about myself, my membership is not transferable and that my affiliation(s) will not be listed in any directories, in print, or on the web.
Membership Fee $150.00
 
  I would like to join both the International Medical Spa Association and The Day Spa Association:
I am a SPA - $510.00                                                    Add'l person $130.00   2nd location $270.00
I am a Supplier/Service Provider (ALLIED) - $640.00   Add'l person $130.00   2nd location $270.00
I am an Individual - $265.00
  I am a member of The Day Spa Association. I would like to join the International Medical Spa Association at the following special rate:
I am joining as a Business - $295.00
I am joining as an Individual - $110.00
 
 
Please include a list of organizations with which you are currently affiliated when submitting your application.
 
 Full Name:           Title:
 
 Company:       
 
 Address:            
 City/Province:                State:
 Country:                   Zip Code:
 
 Telelephone:                    Fax:
 
 Email:                         Website:
 
 I was referred by the following IMSA member: 
 
    I am enclosing my check in the amount of US$
 
    Please charge my credit card in the amount of US$

 Card Type:     Card#:          Exp. (mm/yy):
 Security code (3 digits):
 
I am applying for membership in the International Medical Spa Association, have read the Code of Ethics and agree:
  1. to adhere to and be governed by the International Medical Spa Association Code of Ethics.
  2. to place the safety of my guests and patients ahead of any other consideration.
  3. to support the organization in its efforts to improve the quality of the medical spa industry.
  Signature of Applicant:                                                                           Date: 9/5/2008 8:17:19 PM
 
                                 
 

©2007 The International Medical Spa Association