Maine Ambulance Association

Working Together for Maine

Error
  • [Joomlashack License Key Manager] Joomlashack Framework not found

Membership Application Form

Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Affiliate Member or Call Volume
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Affiliate Member or Call Volume 5,001 - 10,000 calls
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Affiliate Member or Call Volume >10,000 calls
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input

Does your organization believe in and subscribe to the mission and objectives of the Maine Ambulance Association?

Invalid Input
Invalid Input
Invalid Input
Call Volume  
0-500
501-1500
1501-2500
2501-5000
5001-10000
10001+
FY2007  
$195
$390
$585
$780
$1250
$1250
FY2008  
$225
$450
$675
$900
$1500
$1750

Send Payment To:
MAINE AMBULANCE ASSOCIATION
P.O. BOX 202
WATERVILLE, ME 04903-0202

(Maine Ambulance Association Use Only)

Date Rec'dCheck #$Amt Rec'dCall Volume
ApprovedNotifiedMembership YearInitials
© Maine Ambulance Association
No part of this document may be reproduced in any form or by any means without written permission from
Maine Ambulance Association, PO Box 202, Waterville, ME 04903
Invalid Input

Maine Ambulance Association
P.O. Box 202
Waterville, Maine 04903-0202

 

Member Login