Affiliate Membership Application

Instructions

Please complete the Affiliate membership application for your program. Membership runs July 1-June 30, and dues are $250 per year.  Dues cover everyone in the academic program - faculty, clinic directors, and staff. 

When entering the contact information, please use the program director/department chair name, email, and phone number.

Applications are accepted year-round and dues are not pro-rated.

Thank you for your interest in joining CAPCSD as an Affiliate member.


Select An Option
Enter Contact Information
Please select a valid membership option and fee item if exist