Applying for Membership by Mail
Download and complete this PDF File: Membership.pdf.
Please make check payable to VPDP-FL and send to the following address:
VPDP-FL, attention: Ly Nguyen. 4691 Old Canoe Creek Road, Saint Cloud, FL 34769

Applying and Paying for Membership Dues Online:
Complete the online form below and click Register and pay by Paypal or credit cards.


Account Login Details

Create Your Username
e-Mail Address
Confirm e-Mail
Membership Type

Additional Account Details

Last Name:
Middle Name:
First Name:
Professional Designation: MD
DO
DMD
DDS
PharmD
BPharm
OD
Other (Please Specify Below)
.
Specialty:
Street Address:
City:
State:
Phone:
Fax:
Your Website:
Current Status New Member
Renewal
Name of Your Spouse: