South bay pathology society

SOUTH BAY PATHOLOGY SOCIETY

Dear SBPS Members:

The 2017 dues for the SOUTH BAY PATHOLOGY SOCIETY will be $500.
If you are a new pathologist within your first year of practice (recent graduates within the past year), we are offering a special one-year introductory rate of $300.
Please provide the following information below and either:

1. 
   Bring this form with you if you would like to pay me in person at the January meeting; or
   
2. 
   Mail your check, payable to SOUTH BAY PATHOLOGY SOCIETY to your Secretary/Treasurer:
   

Walden Browne

21C Orinda Way

#121

Orinda, CA 94563
If you need a billed invoice, please contact me and I will e-mail you an invoice.
Please note the fees for guests with remain per guest, per meeting.
Please provide the following information with your dues:
NAME:

ADDRESS:
TELEPHONE:

E-MAIL:
PLEASE CHECK BOX IF YOU WOULD LIKE A RECEIPT
If you are sending a check for more than one member, please copy this form and have each member fill it out. Thank you for your prompt response.
Sincerely,
Walden Browne

Secretary/Treasurer SBPS

[e-mail]