Maine Ambulance Association

Working Together for Maine

Membership Application Form

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Affiliate Member or Call Volume
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Affiliate Member or Call Volume 5,001 - 10,000 calls
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Affiliate Member or Call Volume >10,000 calls
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Does your organization believe in and subscribe to the mission and objectives of the Maine Ambulance Association?

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Membership Type  
Affiliate Member
Non-Transporting Service


Ambulance Service
Fewer than 500 calls per year
501 - 1,500 calls per year
1,501 - 2,500 calls per year
2,501 - 5,000 calls per year
5,001 - 10,000 calls per year 
More than 10,000 calls per year

Dues  
$225
$225


Dues
$225
$450
$675
$900
$1,500
$1,750

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

(Maine Ambulance Association Use Only)

Date Rec'd Check # $Amt Rec'd Call Volume
Approved Notified Membership Year Initials

© 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
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Maine Ambulance Association
P.O. Box 202
Waterville, Maine 04903-0202
(207) 209-3944

 

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