Maine Gerontological Society Membership Application
Thank you for using the MGS online membership application form. The MGS membership application process is an easy two step process:

1st step = Application form. Please enter your information below and hit "submit" to complete your application.

2nd step = Payment. Send a check by mail or an online credit card payment via PayPal. If paying by PayPal, you will receive an electronic invoice with a payment link after we process your application. Your application is not considered complete until you have submitted your application form and payment. If you have any questions regarding processing your membership, please contact Ami Esquivel at AEsquivel@une.edu or by phone at (207) 602-2134.

Information regarding application fees:

For those applying for a student membership, a student is defined as anyone attending an institution of higher education. Proof of enrollment in college is necessary. High School is defined as anyone attending grades 9-12. Proof is necessary.

The annual membership year runs from 4/1 through 3/31. Membership fees received after 12/31 will be prorated by 50%

Your Name *
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Your Profession: (i.e. nursing, public adminstration, medicine, social worker, ect.) *
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Mailing Address (Work)-include street, town and zip *
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Mailing Address (Home)-include state town and zip *
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Preferred E-mail Address *
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Preferred Phone *
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Fax
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Individual Membership Option (select one if applicable)
Organizational Membership Option (select one if applicable)
For organizational members, please enter the organization name here.
Your answer
How do you wish to pay? *
We welcome contributions to support MGS's work. If you would like to make a contribution in addition to your membership fee, please indicate the amount here.
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Visit the Maine Gerontological Society website for an explanation of member benefits and other great information:
https://mainecenteronaging.umaine.edu/maine-gerontological-society/

Please press "submit" below to submit your application to MGS. You will receive a confirmation shortly.

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