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ADMC Application

Instructions

Please provide the following information.  The ADMC application process includes completing this application, paying the fee, and submitting the required documents.  

Select An Option

$750 Application Fee + $50 Enrollment Fee
DMC must be in business for at least five (5) years.

$1000 Application Fee + $50 Enrollment Fee
Fast Track is an option only if the DMC has been in business for at least 3 years and is owned or was started as an expansion office by an existing ADMC in good standing.

$1500 Application Fee + $100 Enrollment Fee
DMC must be in business for at least five (5) years.

$2000 Application Fee + $100 Enrollment Fee
Fast Track is an option only if the DMC has been in business for at least 3 years and is owned or was started as an expansion office by an existing ADMC in good standing.

Enter Contact Information
Please select a valid membership option and fee item if exist
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