This document is an application for membership in the Family Care Advantage Plan, a discount medical plan offered by Association Heath Care Management, Inc. It collects personal information from applicants such as name, address, date of birth, and payment details. Membership costs $49.95 per month plus a one-time $50 application fee. The plan provides discounts on dental care, pharmacy costs, lab tests, and imaging services. Applicants must initial that they understand Family Care is not insurance before signing to apply.