New Member / Renewal Application

To become a member or to renew your membership, please fill out the form below.

Membership dues are paid annually and are due on April 30th of each year. Annual membership fees are as follows:

Individual  $ 10.00 | Board Members  $ 25.00 | Corporate Membership  $ 250.00

Membership Dues may be paid via PayPal, by clicking here or by check. If paid by check, please make check payable to Diabetes Coalition of Palm Beach County, and mail to: Keiser University, 2085 Vista Parkway, West Palm Beach, FL 33411, attn: Barbara Jacobowitz.

Indicate on Check Notation Block, that the check is for: Diabetes Coalition Membership Dues. 

New Member / Renewal Application