* = REQUIRED FIELDS. THESE DISCOUNTED RATES ARE AVAILABLE TO MEMBERS OF THE TEXAS NURSES ASSOCIATION WHO ENROLL BEFORE DECEMBER 31, 2019.
Choose which Global Medevac enrollment option is best for you: * Individual Monthly Plan $30/moFamily Monthly Plan $38/moIndividual Annual Plan $350/yrFamily Annual Plan $450/yrIndividual 5-Year Plan $2250Family 5-Year Plan $3150Individual Lifetime Plan $2850Family Lifetime Plan $3850
Note: Preexisting conditions are covered after 90-days
First Name *
Middle Name *
Last Name *
Birthdate *
Age *
Your Email *
Mobile Phone Number *
First Name
Middle Name
Last Name
Birthdate
Age
Spouse Email
Mobile Phone
Street Address *
City *
State *
Zip *
Note: a Global Medevac agent will reach out to you to process your payment
Annual Check/Money Order PaymentAnnual Credit/Debit Card PaymentEFT/ACH Payment
Agent Number
(help someone else gain the ultimate peace of mind)
Email
Mobile Phone Number
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I have received, read and understand the Global Medevac Membership Agreement.