2024 VA-AAP Membership Form

AAP VA Chapter Application for Membership
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Upon completion you will be taken to a secure dues payment system.

Name*

First NameLast NameSuffix

Subspecialty*

Pronouns*

Office Phone*

Please enter a valid phone number.

Mobile/Home Phone

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Email*

example@example.com

Preferred Mailing Address/Street Address*

Street Address

Street Address Line 2

CityState

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Please Select Membership Category:
Please note dues amount for selected category and be prepared to submit payment with a major credit card on the Affinity Pay Secure Payment page.

Select One and Note Dues Amount:*

$205 Chapter Fellow (Current AAP Fellow)$205 Member, Virginia Pediatric Society (Not an AAP Fellow, but trained and practicing pediatrics in Virginia)$205 Affiliate Member (Physicians or dentists practicing in other specialties relating to pediatrics)$130 Married Fellow or Society Member (Both spouses are members)$130 Candidate (Limited to four years after completing PL-3 training.)$105 Allied Health Professional (NP, PA) or Practice Manager$60 Senior Member (Age 65+)$0 Resident or Medical Student