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Application

To apply for membership in FPRA, click the following link which will open a separate window with an application in Adobe Acrobat format. Please print the form, fill it out in its entirety, and return it to:

Diana Clynes, Program Manager
American Association of Kidney Patients
3505 East Frontage Road, Suite 315
Tampa, FL 33607

Along with:

A copy of your resume and
A check for the appropriate dues and processing fee.

Membership Application (Adobe Acrobat)