Membership Application

Membership Category

A Fellow member of this Association is certified by the National Commission on Certification of Physician Assistants (NCCPA) who shall be employed within, or be a participant of a urology practice or have worked in urology or have an interest in urological medicine. A Fellow Member must hold simultaneous membership in the American Academy of Physician Assistants. A Fellow member shall enjoy the rights and privileges of the Association including the privilege of the floor, to hold formal office or positions of the Association, and to vote.
An Associate member is any person who conforms to the criteria for Fellow membership, but who chooses not to or is not qualified to hold membership in the American Academy of Physician Assistants. Certified Nurse Practitioners or Physician Assistants who are credentialed in a foreign country or who received their education as a physician assistant in a foreign country may join as Associate members. As an Associate Member, he or she may hold a committee position, may attend all meetings, may introduce business at all meetings of the Association, and may vote during the general membership meeting. An Associate member may not vote on issues that impact on the American Academy of Physician Assistants, or become an officer or representative of the Association.
A Student member shall be any person who is enrolled in an officially recognized residency or fellowship program in urology or holds a direct interest in pursuing a career in urology practice. Student members shall not vote on issues pertaining to the AAPA and shall not hold office.

Applicant Information

Applicant Addresses

Office Address

Home Address

Payment Information (must be made in U.S. dollars)

  • Billing Information

If paying by check, make check payable to: Urological Association of Physician Assistants

Mail payment to:
Urological Association of Physician Assistants
Two Woodfield Lake
1100 E. Woodfield Road, Suite 350
Schaumburg, IL 60173

  • 992122