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Get American Registry of Medical Assistants Reinstatement Request for Certification of Registration 2017

NSTATMENT FEE $80 This form is for Reinstatement of your membership which has lapsed for more than one year, OR if you have not Renewed your membership by April 30th of the current year. * All Stared Fields Are Required To Process Your Request *Name: *Address: *City: *Email Address: *Registration #: *Apt #:______ *Phone #: *State: *Zip: -* (4 Digit Extension) *Social Security (Last 4 Digits) :_________*Birthdate: ___ / ___ / ___ Reinstatement Certification Registration Fee and Docment Requir.

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