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Australian Medical Association (NSW)

Membership Application

You are invited to join AMA. Your membership application is subject to verification of your status as a registered medical practitioner.

This is an abbreviated application to make it simple for you to join.

All new membership subscription rates quoted are pro rata

Australian Medical Association Limited Sign Up
 * - denotes required field
** - either a combination of state and zip OR a country is required
 
Personal Information
Last Name:*
First Name:*
Middle Name:
EMail:*
Prefix:
Work Phone:
Mobile:
Business
Preferred: Mailing  Billing
Address: *
  
  
City:*
State:***
Postcode:**
Country:**
Student applicants, please provide school information
Medical school:
University Year:
Year Start Med School:
All applicants, please select a type of membership, discipline and primary reason for joining
Type of Membership:*
Reason for Joining?:
If other please describe:
Enter Discipline - If Doctor In Training or General Practice member type select that discipline:
Hospital Appointments:
Position:
Security Insert
Login:*
New Password:*
Verify New Password:*
 

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