AHHA GENERAL MEMBERSHIP APPLICATION


You can use the application form on this page to fill out and submit the application online
OR
You can download and printout an application form to fill out and mail in.

APPLICANT'S CONFIDENTIAL INFORMATION - for use by AHHA only:
This contribution is from an individual a company
Full Name:
Organization:
Work Phone:
Home Phone:
Cell Phone:
Email:
Website:
MAIL TO ADDRESS:
Street Address:
City:
State:
Zipcode:
Country:

GENERAL MEMBERS QUALIFY FOR DISCOUNTS, 2 EDUCATIONAL VIDEO LISTINGS, 1 FACEBOOK POSTING,
AND BI-MONTHLY AHHA Members Only Newsletter


MEMBER LOGIN:
Each AHHA membership has a login/password for access to the online AHHA Members Only Section. Designate an email that can be used in case you forget your password in the future. It is best to use a personal email.
Login-related email to use:

AHHA's GO GREEN options:
AHHA strives to go green and minimize our paper consumption
  • Your membership contribution receipt is emailed to you
  • Thank You Packet materials and bi-monthly member newsletter issues are accessed online in the Members Only Section
    While we are happy to mail you specific materials, we ask you to verify what you wish to receive...
  • To receive your booklet by mail you must check the following box
               Yes, mail me copy of booklet Wellness From Within: The First Step

    Is your Mail To address outside of the U.S.? Then you need to prepay mailing costs of any materials sent to you.

  • MESSAGE TO AHHA:
    This area is provided to offer you an opportunity to send a special message to AHHA.

    CONTRIBUTION INFORMATION:
    AHHA is a designated 501(C)(3) - Tax ID# 33-041271
    Contributions are tax deductible as allowed by law


    BASIC
    $30

    FOREIGN POSTAGE
    $



    EXTRA
    $













    TOTAL
    $


    BASIC AHHA MEMBERSHIP CONTRIBUTION
    AHHA General Membership contribution for the next 12 months


    For non-U.S. addresses - add mailing costs for any requested mailed materials


    ADDITIONAL DONATION
    Contributing an additional amount to expand the outreach of this valuable organization
    Over and above the basic contribution above, I donate an additional donation amount
    Platinum Circle = $500 or more
    Gold Circle = $250 - $499
    Silver Circle = $100 - $249
    Bronze Circle = $50 - $99
    Extra Gift = $49 or less

    With permission of the donor, an extra donation over and above the basic membership contribution amount is acknowledged in the Honored Donors section of our website at ahha.org/donors.asp with the name of the donor. Gold and Platinum Circle level donors can add a hyperlink.
    I grant permission to be added to the Honored Donors list

    COMBINED SUPPORT TO AHHA
    Type in the TOTAL AMOUNT you intend to contribute to AHHA.
    This is the SUM of basic membership contribution, plus mailing costs (if requested materials mailed to non-U.S. address), plus any additional donation you would like to make.

    Print out a copy of all of the above for your records, as back up in case of a technical glitch in information transfer.

    SUBMIT APPLICATION INFORMATION TO AHHA:

    Method will use to make membership contribution
    After you click on SUBMIT button, you are transferred to the payment information screen.
    Option #1 is to mail a check or money order to AHHA.
    Option #2 is to use your Visa, MasterCard, or DiscoverCard. For this there will be a button to transfer you to the Authorize.net secure website. Once there you enter the amount you are donating, then transfer to a form on the Authorize.net secure server where you enter your confidential credit card information.