AHHA ORGANIZATIONAL MEMBERSHIP APPLICATION


You can use the online renewal form on this page to fill out and submit AND then access Authorize.net or PayPal for an online credit card transaction OR then mail a check or money order to AHHA.
OR
You can download and printout an application form to fill out and mail with check or money order to AHHA.

APPLYING ORGANIZATION'S NAME:
Organization Name:
APPLYING ORGANIZATION'S CONFIDENTIAL CONTACT INFORMATION:
This information is kept confidential, unless authorized elsewhere for inclusion in listing.
Contact Person Name/Title:
Contact Person Phone:
Contact Person Email:
Mail To Street Address:
Mail To City:
Mail To State:
Mail To Zipcode:
Mail To Country:

MEMBER LOGIN:
Each AHHA membership has a login with UserId & 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 an email with limited access.
Login-related email to use:

AHHA IS PAPERLESS
Your AHHA membership contribution receipt is emailed to you.
Your AHHA membership certificated is emailed to you.
The bi-monthly member newsletter issues are accessed online in the password-protected Members Only Section.

APPLICANT'S QUALIFYING CRITERIA:
To qualify as an AHHA Organizational Member your company/organization must:
  • offer a product, service, or educational opportunity that enhances health and well-being
  • encourage a holistic approach to creating wellness
List what health-related products, services, or educational opportunities your company/organization offers:
ORGANIZATION'S AUTHORIZED DATA FOR PUBLIC LISTING - shared with the general public:
The following information is authorized to be in the AHHA Organizational Member's listing shared with the general public in print and online.
Organization Name:
Street Address:
City:
State:
Zipcode:
Country:
Phone:
Email:
Website:
Descriptive Text:
Describe what types of products/services are offered; why someone would want them; how customers can obtain them. Space limits restrict this field to approximately 70 words or about 480 characters (dictated by printed version of list).

Listing Category:
Position our company/organization under the following heading on the networking list:
MEMBERSHIP REQUEST:
Yes, our company/organization encourages a holistic approach to wellness where individuals:
  • Balance and integrate themselves physically, mentally, emotionally, and spiritually
  • Establish healthy and respectful relationships with others and the world around them
  • Make lifestyle choices that promote their wellness
  • Participate actively in their own health decisions and healing process.
Yes, our company/organization grants permission for release of the authorized information for the AHHA Organizational Member networking list and other public relations opportunities.

Yes, our company/organization wants to become an Organizational Member of the AMERICAN HOLISTIC HEALTH ASSOCIATION and certifies that the information provided above is accurate.

NOTE: For a legal equivalent of your signature in response to the above questions you must enter your full name and today's date in the Signature field below.
MANDATORY SIGNATURE: (enter your full name and today's date)


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
$110


EXTRA
$


















TOTAL
$


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


ADDITIONAL DONATION
Contributing an additional amount to expand the outreach of this valuable organization
Over and above the basic contribution above, we donate an additional donation amount
Platinum Circle = $500 or more
Gold Circle = $250 - $499
Silver Circle = $100 - $249
Bronze Circle = $50 - $99
Copper Circle = $5 - $49

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/honored-donors with the name of the donor. Gold and Platinum Circle level donors can add a hyperlink.
We 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 any additional donation you would like to make.

We strongly recommend that you 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:

IMPORTANT: THIS FORM DOES NOT MAKE YOUR PAYMENT.
BELOW YOU INDICATE WHICH OPTION YOU WILL USE TO MAKE YOUR CONTRIBUTION.
 Select one from the following menu:
Pick Option #1 to indicate you plan to use your credit card to make your membership contribution.
Pick Option #2 to indicate you plan to mail a check or money order to AHHA to make your membership contribution.
Method you will use to make membership contribution

Now click on SUBMIT button below so that the data you entered above is emailed to AHHA.
After you hit the SUBMIT button, you will be transferred to a new page with links to secure payment options by credit card.