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MNS Membership Form

MNS Category
Regular Member
APP/Other
Resident
Medical Student
Current MNA Member
Yes
No
I am interested in learning more about positions on the Board:
Yes
No

Annual Dues:

  • Regular and APP Members (July 1 – June 30): $25.00

  • Discounted Five-Year Membership Fee: $100.00

  • Residents and Medical Students: Free

Payment: Please submit this form even if you don’t need to pay dues.

Make checks payable to Maine Neurological Society and mail to:

Maine Neurological Society

c/o Dianna Poulin, Executive Director

507 East Jay Rd

Jay, ME 04239

Amount to be mailed:
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