Blair Chiropractic Society

member log in    |    become a member

Become a Member of the Blair Chiropractic Society

The Blair Society relies on membership dues to support the web site, research projects, student scholarships and field doctor education and proficiency certification.

I want to take this time to thank all of you who have already joined or renewed your membership this year. For those of you who would like to do so, membership is as follows:

  • DC Member - Doctor of Chiropractic $200.00 (First year free for new graduates)
  • Faculty member - Faculty of a chiropractic college FREE
  • Student member - Student at a chiropractic college FREE

To apply for membership, please complete the form below. When you submit your application you will have the option of paying with a credit card. If you would rather pay by check please make the check payable to Blair Chiropractic Society and mail to:  Blair Chiropractic Society  c/o  Dr. Margaret Banitch, 41 Plymouth St, Montclair, NJ  07042

Is This a New Application or a Renewal?

Type of Membership



Level of Blair Work


Do you have Blair head clamps?

Do you take stereo x-rays?

Do you use a side-posture/drop-headpiece table?

Name: 
Address:
City: 
State:
Zip:
-
Telephone:
Email:
Please choose a password:
Retype your password: