Kansas Medical Group Management Association

Application for Membership

Please print to fill out the Application for Membership form and attach a check payable to KMGMA for the appropriate category:

Individual $100.00; Allied $200.00; Student $25.00; Group 1-5 members $400.00; 6-10 members $750.00. Each individual must submit an application. Group membership must be submitted together.

MAIL TO:

Claire Daniels, Executive Assistant
KMGMA Membership Committee
5051 E. Lincoln, #4C
Wichita, KS 67218

Phone: (316) 686-4414

E-mail: cdaniels1@cox.net