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  Enrollment Form

Enroll in AMWA's Certificate Program

Complete information about AMWA’s Education and Certificate programs

Join now and enroll at the lower member rates.

 Information for enrollment

* = Required fields

* First name:
* Last name:
* Address:
* City:
ZIP/Postal code:
Daytime phone:
(xxx) xxx-xxxx
(xxx) xxx-xxxx
 Certificate Enrollments (all are good for 6 years). Enrollments do not include the cost of the workshops.:
Essential Skills certificate:
Member $150
Nonmember $275
Specialty certificates (require completion of an Essential Skills certificate, or previous Core or Advanced certificate, to earn)*:
Member $150
Nonmember $275
Composition and Publication
Member $150
Nonmember $275
Concepts in Science and Medicine
Member $150
Nonmember $275
Regulatory and Research
Member $150
Nonmember $275
Advanced specialty certificates (enrollments will be available later but will require completion of the relevant specialty certificate to enroll)

*While you may enroll in these specialty certificates and take applicable workshops, you may not earn the certificate before completing the Essential Skills certificate or having a Core or Advanced certificate.
Certificate Enrollment Extensions (good for 4 years from the expiration of the original enrollment; for those who need additional time to complete their certificate requirements):
Member $85
Nonmember $210
Member $95
Nonmember $220
If you have taken an AMWA workshop(s) within the past 90 days that you would like to receive credit for, please complete the following:
  Workshop location(s)
  Workshop title(s)
 Payment Information:

If you do not wish to submit this secure form electronically, print it and either attach your check or fill in your credit card information after printing and mail to AMWA or for credit card payments only fax to (301) 294-9006.

30 West Gude Drive Suite 525
Rockville, MD 20850-4347

* Credit card:
* Credit card number:
(ex: 1234 567890 12345)
* Credit card expiration:  mm: yyyy:


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