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If you would like to become a member of RAMA Ohio, please, read the information provided in section "About" of the website and complete this form. All applications are reviewed by the RAMA Membership Committee. Please, allow one month for review. Membership becomes effective on the date of approval and upon payment of membership fee. Membership certificates will be mailed upon approval of the membership and receipt of dues. We will respond to your request through e-mail.

Membership dues are:

Physicians Residents Students
12 months $100 $50 $15

Requests for membership can be sent via snail mail or e-mail, or you can fill in the form below. Send mail/e-mail to:
Yevgeniy A. Khavkin M.D.
Secretary of RAMA
Assistant Professor of Neurosurgery and Oncology
Northwestern University, Feinberg School of Medicine
2650 Ridge Avenue
Evanston, IL 60201
khavkin@aol.com

Membership dues can be paid online or by sending them to this address; make checks payable to "RAMA":
36100 Euclid Avenue, Suite 330-B
Willoughby, OH 44094

You can request membership through this form:

Fields marked with a * are required. All data will be made public except for your email address and contact address.

For your contact address, please include your full work or home address along with phone and fax numbers.
For the details, enter any information that you consider important, such as your website if you have one, along with a brief description of yourself.
Your picture, if you provide one, must be a JPEG file no bigger than 97kb.