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                 Day Spa and Int'l Medical Spa Association Membership Application

Please fill out completely and hit the Submit button to send us through our secure server. Any
questions? Feel free to call Toll Free 877-851-8998. Thank you, Allan Share, President


Dual membership rates with the International Medical Spa Association available. Please contact the DSA/IMSA office at 877-851-8998 or 952-767-2202 for further details.

   
*Please check membership:
Spa Membership:                            Other: 
    $199.00 per year    
(Multiple locations for an additional $99.50 per location, please call.)
 
Medical Spa Membership:                          Other: 
    $199.00 per year
 
Individual Membership:                     Other: 
    $49.00 per year  
 
DSA Accredited Spa Membership  Apply Here
 
Application Type: New              Renewal
*Full Name:
 Title:
*Company:
*Address:
*City/Province:
*State:
*Country:
*Zip:
*Phone:
 Fax:
 *Your E-mail: 
 Web Address:
   
                                                                 If you'd prefer to mail a check, send your remittance to:

Payment Info:                                       DSA/IMSA, 2863 Hedberg Drive, Minnetonka, MN 55305-3406

   
       *Credit Card
       *Cardholder Name
       *Card Number
       *Expiration Date (mm/yy format)
       *Security Code Whats This?
       *Address (If different from above.)