SC OMA: Professional Member Application

By becoming a member of the South Carolina Oriental Medicine Association you can play a vital role in further establishing your profession in South Carolina, and ensure that you are kept up-to-date on legal news. You will also have access to a forum to discuss issues with your peers. [read more]

* fields are required.
Personal Information
First Name	*	M.I.
Last Name	*
Gender
Mailing Address	*
City	*
State	*
Zip Code	*
E-Mail Address	*
Home Phone	*
Alternate Phone
Acupuncture License Number
Professional Information
Title	*
Practice/Clinic Name
Clinic Address
E-mail Address
Work Phone
Website:
Areas of special interests/intentions for future practice (i.e. women's health, nutrition, etc)	*
Voting Zip	*
SCOMA Interests
Advertising Opportunities
Volunteer Opportunities
SCOMA Board Membership
Other Activism:

After you hit submit, you will be taken to a new page where you will be able to
select your membership type.
You will then be taken to PayPal's website to complete payment.
*It is not necessary to have a PayPal account.