Individual Membership Application

Individual membership entitles the member to attend all Mid-Carolina AHEC programs (LIVE, ALP (SC AHEC Learning Portal) live and enduring programs) at no charge for registration (Note: Consortium membership excludes ACLS, BLS, PALS or Joint Providership programs). Meals, registration fees and books, if required for a specific program are not included in consortium membership. Membership is non-transferable and membership fees are non-refundable.

Start accessing these benefits today by completing and submitting the individual membership application form below. Please note there is a $5 online processing fee when paying online. If you prefer, you can download the membership application form HERE and mail your application along with payment to the address below.

If paying by check or MO:
Please mail completed membership application (downloadable here - PDF) with a check or MO for $250.00 made payable to:
Mid-Carolina AHEC
PO Box 2049
Lancaster, SC 29721
Phone (803) 286-4121- Fax (803) 286-4165

Name *

Licensure/Credentials *

Home Address *

Address (extra field)

City *

State *

Zip *

Home/Cell # *

Email Address *

Employer *

Employer Address

Business #

Fee *

Annual Membership [$255.00]