Membership Application

Click here to download a Word version of the Membership-Application.

Please type application and use additional space as needed to provide updated information. Please mail your completed application and your institutional membership fee of $100 by August 1, 2017 to:
Marjorie Neidecker, PhD, RN

Treasurer, CoAPCR

7623 Kestrel Way West

Dublin OH 43017

614-302-3904 Mobile