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Payment for Payment of Dues

Dues Statement

South Carolina Society of Pathology

Please Indicate Below Your Current Year Membership Classification

First Name*

Last Name*

Address*

City*

State*

Zip*

Office Telephone Number

Fax

Email*

Previous Dues Owed

Member Classification*

Active Academic Member Employed Full Time In A Medical School Or University - $100.00

Total Amount

Payment method

Paypal

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Type*

Card Holder Name*