MEMBERSHIP APPLICATION

Please fill out the application form below. After submitting the form, you’ll be redirected to PayPal where you will pay the yearly membership dues with any major Credit Card (Note: there will be a 4% surcharge) or by using your PayPal account. If you’d like to avoid the surcharge and send a check, please download the application form and mail your yearly membership dues to Dr. Peter Brukasz, M.D., President of the PAMS, at the following address: 1450 W. Lake Street, Suite 101, Addison, IL 60101.