2019 – 2020 Membership Application

Student Information
Are you an executive board officer at your local SABCA chapter?*
- Yes
- No
What is your board position?*
Your position in the chapter
School Attending:*
Quarter/Trimester
Anticipated Graduation Date:*
Date Format: MM slash DD slash YYYY
Practice Information
Are you currently in practice?*
- Yes
- No
- Retired
Practice Name*
Were you ever in active practice?*
- Yes
- No
Practice Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Practice Website
Years in Practice?*
Please enter a number less than or equal to 100.
Chiropractic College Attended:*
Graduation Date:*
Date Format: MM slash DD slash YYYY

Type of Membership - (Annual renewals unless noted otherwise)
Membership fees reflected here are for 2019-2020 and are subject to change.
Doctor
DC memberships in the ABCA are annual unless otherwise noted by a Lifetime commitment. The member year expires at the conclusion of the last business session of the ABCA National Convention.
Lifetime:
Price: $1,300.00
Lifetime memberships paid through June 1, 2020 do NOT include registration for the 2021 National Convention. Lifetime Members must complete registration and pay registration fees for the annual national convention separately.
Select Doctor Membership Type*
- 1st Year Doctor
- Doctor (DC)
1st Year Doctor - First Year Free
Price: $5.00
*DC's in their first year after graduation who were SABCA members while in chiropractic college. First year doctors must send proof of graduation date (copy of graduation diploma) to info@abcachiro.com or upload the file directly below. There is a $5.00 administration fee when applying on-line.
Doctor (DC):
Price: $175.00
Doctor (DC) memberships include a listing in the "Find a Doctor" page on the website and eligibility to participate in our 2020 Elections.
Student
Student memberships in SABCA are for the duration of time a student is enrolled in chiropractic college. (Approximately 4-5 years). SABCA National Dues may be paid anytime during attendance in chiropractic college. Each SABCA chapter pays National dues annually.
Student (SABCA Member) – 1 time fee:
Price: $50.00
Members in the National SABCA organization are eligible to apply for the Harvey Lillard Scholarship. Student members do not have to renew their membership each year as the $50 fee covers them for the duration of time they are enrolled in a Chiropractic program. However, each year, students must pay registration fees for our annual national convention. Register for the National Convention here http://abcachiro.com/convention-registration/
Chapter Dues (Annually)
Price: $50.00
Each student chapter must pay a yearly fee of $50 for membership in the National SABCA organization.
Important:
Please Note: The credit card billing address must match the address on file with the bank. If the addresses no not match, the transaction will be declined.
Total
$0.00
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Credit Card Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please Note: The credit card billing address must match the address on file with the bank. If the addresses no not match, the transaction will be declined.

2019 – 2020 Membership Application

Step 1 of 3

Personal Information

Student Information

Practice Information

Type of Membership - (Annual renewals unless noted otherwise)

Doctor

Student

Important: