Membership Dues Payments If you are human, leave this field blank. MOMS/NMA 2018 Membership Dues Payment Physician's Name * As it appears on your Membership Dues Invoice Member ID Appears in the lower left corner of your Membership Dues Invoice Member Email Payment Receipt Email A credit card receipt will be sent to the email address listed here. If blank, no receipt will be sent. Billing Changes Please indicate any changes you would like made to your billing contact or address for future billing. Please indicate the dollar amount for each item included in your payment The Metro Omaha Medical Society and Nebraska Medical Association are partner organizations -- membership in both is required. Required Dues Amount * Amount selected from Required Dues section of your renewal notice NMPAC - Physician (Optional) $200 NMPAC Member OR $300 NMPAC Major Donor NMPAC - Spouse (Optional) $200 NMPAC Member OR $300 NMPAC Major Donor MOMS Foundation Donation (Optional) $50 recommended. Any amount accepted. Used for community grants. MOMS Foundation Match Program Donation (Optional) Will benefit the Omaha Healthy Kids Alliance Project Air program. NMA Foundation Donation (Optional) $50 recommended. Any amount accepted. Spouse Alliance Membership (Optional) $50 AMA; $20 NMA; $70 for both (spouse auxiliaries) reCAPTCHA
