Membership

Please use the form below to apply for membership or to renew your membership. Dues are $35.00 per year for individuals and $50 per year for companies.

Our registration system uses PayPal for payment. Note that you can make a payment using a credit card without creating a PayPal account, if you choose to do so. Where it asks you to login to your PayPal account, just click below where it says “pay with a debit or credit card”.

For questions related to membership, please contact:
Marietta Bellamy Bibbs
mariettabibbs@southernsleepsociety.org

If you prefer to pay by check, please use our printable membership form.

Membership Application/Renewal Form

Member Info
First Name
Last Name
Address
City
State or Province
Zip/Postal Code
Country
Phone
Fax
Email Address

Affiliation Info
Affiliation
Address
City
State or Province
Zip/Postal Code
Country

Corporate Contact
First Name
Last Name
Address
City
State or Province
Zip/Postal Code
Country

Additional Questions

Please check all that apply:

Committee interest:

Membership type:

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