Join The Wyoming Chiropractic Association
Wyoming Chiropractic Association Membership Application
Please complete the form below and click the SUBMIT button to be directed to the PayPal page for payment options.
Name
Clinic Name
Clinic Address
City
State
Zip
Clinic Telephone
Cell Phone
Years in practice in Wyoming
Wyoming License #
Other states currently licensed
I may be interested in serving on a WCA commitee
I may be interested in serving on the WCA board of Directors
Dues are deductible as an ordinary business expense. Contributions or gifts to the Wyoming Chiropractic Association PAC are not tax deductible. The WCA estimates that the non-deductible portion of your annual dues - the portion which is allocated to lobbying/PAC account is 7%.
By submitting this application and dues for membership in the Wyoming Chiropractic Association, I agree to uphold the ethics and laws of Chiropractic in the state of Wyoming and to remain in good standing with the WCA by timely payment of dues as set by the membership.
Membership Dues
$25.00 Student
$150.00 First Year Graduate
$350.00 Regular Yearly Membership
 | ||||||
If you do not want to use PayPal and want to pay by personal check, DO NOT COMPLETE THE ABOVE FORM OR CLICK THE SUBMIT BUTTON. Print and complete the above application and send it with a check to:
Wyoming Chiropractic Association Membership Application
1334 Heathrow Avenue
Casper, Wyoming 82609
email address
I am joining the WCA and attending the Spring Seminar
