Membership

​MEMBERSHIP REGISTRATION FORM

First Name: *

Last Name:*

Street Address: *

City: *

Zip Code: *

State: *

Office Phone: *

Cell Phone Number:

Fax:

License Numbers: *

Date of Birth: *

Email: *

I am a member of the CPAA - Chiropractic Physician Association of America *
YesNo

Do you believe that chiropractors should have Injectable Nutrition Rights *
YesNoUndecided

How did you hear about us?:*

Are you interested in getting involved in advancing our laws? *
YesNo

I am: *
DCMDLMTCCPACPAOther

Comments:

Payment Buttons

Membership Fees:

Membership is free for the first year for all FL DC’s and then there is a $99 annual dues fee.

Membership Volunteer

Suggested amount Membership Volunteer Lobby/Legislative  Dues: 99+25=124

Out of State Voluntary Dues

Your donation will help us in our quest to expand your rights. The entire nation is watching us now. Tens of thousands of DCs are thinking about what we represent and if they should join us; and they are.

If you want to pay by check please make it payable to:

FCPA mailing address:

2225 NW 2nd Ave, Cape Coral, FL 33993

Note: Please let us know when you send a check

Close Menu