National Association of Managed Care Physicians

Corporate Membership Application

   

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Name: Title:
Company: E-mail:
Address: City:
Telephone: State:
Fax: Zip:
Referred By:     
 

Benefits

 Grand Patron
$25,000		 Corporate Patron
$15,000		 Patron
$10,000		 Benefactor
$5,000		 Partner
$2,500
Complimentary Individual Memberships 25 20 15 10 5
1 Full Page 4-Color Ad
Journal of Managed Care Medicine (JMCM)		 4 Issues PLUS 25% discount on all advertising 2 Issues PLUS 25% discount on all advertising 15% Discount
All Advertising		 10% Discount
All Advertising		 5% Discount
All Advertising
Managed Care eNews Logo & Text Ad
4 weeks (one Month)		 Logo & Text Ad
2 weeks (one Month)		 Logo, 2 weeks
(1 Month)		 N/A N/A 
Value-Added Membership Benefits:
  • Subscription to the Journal of Managed Care Medicine (JMCM)  - Opportunity to publish articles in peer-reviewed
Journal (see publications page on www.namcp.org)
  • Discounts to all Symposia and Conferences of the Medical Directors Institute of NAMCP
  • Symposia and Conferences - present clinical, evidence-based, disease management topics; network with attendees and reach NAMCP's
database of over 14,000 medical directors and physician executive members with a published article of your presentation in the following issue of JMCM.

  • Special corporate member discounts based upon level of membership and sponsorship of conference(s).

  • Discounts for all members on sponsorship and exhibit opportunities

  • Website hyperlink – Run Quarterly press releases with links to your website from NAMCP's website

  • Access to NAMCP corporate staff and deep pool of medical directors for faculty participation in advisory boards, consensus board, focus groups, mock P&T committees, NCQA quality improvement activities, NDA review boards, disease management standards committees/strategic advisory team projects

  • All programs and enduring materials available at special discounts to “Patrons”

Level of Participation:


Payment:
If Paying by Check, Check #:
Card Type: MasterCard   Visa   American Express
Credit Card #:
Expiration Date:
3 Digit CVV2 Code on Back of Card:
Cardholder Name:
Billing address is same as above:
Credit Card Billing Address:
City:
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Zip:
If you are mailing or faxing this to us please have cardholder sign here:
Please Send Receipt by: Fax number from above
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Comments:   
For Additional Information phone: 804-527-1905
or
email: bwilliams@namcp.org
Federal ID: 54-1566359  non-profit organization

You may also print this form and either mail or fax to the below locations:
Mail form to NAMCP, 4435 Waterfront Drive, Suite 101, Glen Allen, VA  23060
or
Fax to 804-747-5316

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