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Florida Professionals in Infection Control
FPIC
Control, Education, Prevention, Surveillance  
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  HOMEIN THE NEWSTHE BOARDMEMBER RESOURCESIP RESOURCESCONTACT USLEGISLATIVE UPDATECONFERENCE


Annual Cost $45.00 

Payment OPTIONS:
Secure link via:
PAYPAL

or

Pay by CHECK
​1) Complete application first, online preferred.

2) Ensure your name is on the check.

3) Mail check to: Membership Chair,
Bill Hepler
1319 Roosevelt Dr
St Augustine, FL 32084



See printable
APPLICATION
for more details.

If preferred, may FAX printed application to:
    904-808-1401.
2017 Annual MEMBERSHIP APPLICATION

FPIC Member #
Last Name
First Name
FL Professional License #
Mailing Address
City
State
ZIP
E-Mail Address
Employer
Employer Address
City
State
ZIP
Preferred Phone #
FAX #
# Years in IC/IP/EH
CIC Certified?
Degree(s)
Select Area of Practice
Would you be interested in volunteering with FPIC?
Select
Payment Type
IF INTERESTED IN
VOLUNTEERING

APPLY HERE

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YesNo
Yes, I would consider volunteering
No, not interested in volunteering at this time
New Member Renewal
PayPal
Check, to be mailed
Check, paid at conference
Cash, paid at conference. Email receipt.