LATEMS Member additional chapter------- LaTatical Emergency Medical Society (LaTEMS) Subscription

Please enter information on the form below to process subscription for LATEMS Member additional chapter------- LaTatical Emergency Medical Society (LaTEMS). The price you have to pay is $15.00.

Please mail your payment to the following address:
LANREMT
P.O. Box 86456
Baton Rouge, LA 70879-6456

Once we receive your membership, your membership will be changed from pending to active.

Avatar

Username*

Password*

Retype Password *

First Name *

Last Name *

Address

Address2

City

Zip

State

Phone

Email *

Level *

National Registry Number:

Expiration Date

Primary Occupation

Employer

Address (Work)

City (Work)

State (Work)

Zip (Work)

Telephone (Work)

Cell Phone (Work)

Email (Work)

Payment Information

Coupon

Payment Terms

$15.00 for each Year

Regular subscription price

Regular subscription discount amount

Regular subscription tax

Payment Fee

Regular gross amount

Payment Method *

Paypal

Offline Payment

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*

LATEMS Member additional chapter------- LaTatical Emergency Medical Society (LaTEMS) Subscription

New User? Please register

Account Information

Payment Information

LATEMS Member additional chapter------- LaTatical Emergency Medical Society (LaTEMS) Subscription

Existing user? Please login

New User? Please register

Account Information

Payment Information