Membership Form

Welcome! Once you fill out the form below and click 'Submit', you will be directed to the online dues payment page.

Please note the different membership categories and select accordingly.

Thank you for joining us!

I'm interested in volunteering!

Cinderella Dress Day- sort dresses, alterations, work event, set up/clean up

Doctor's Day- donate food bag, work event shift, set up/clean up

Medical School Support- provide meals, snacks, beverages for students

Membership Committee Support- help with member engagement, new member welcome

Communications Support- assist with public relations and media management

Call us:

260 - 420 - 1011

Find us:

709 Clay St. Suite 101

Fort Wayne, IN 46802