MEMBER CONFIDENTIAL CONTACT INFORMATION - for use by AHHA only:
MAIL TO ADDRESS:
MESSAGE TO AHHA:
Mention any updates needed for your listing.
AHHA is a designated 501(C)(3) - Tax ID# 33-041271 Contributions are tax deductible as allowed by law
BASIC AHHA MEMBERSHIP CONTRIBUTION
AHHA Membership annual renewal contribution
Membership amounts are General=$30; Practitioner=$60; Organizational=$110. If renewing BEFORE membership expiration, discounted rates are General=$25; Practitioner=$50; Organizational=$100.
For non-U.S. addresses - add mailing costs for any requested mailed materials
Contributing an additional amount to expand the outreach of this valuable organization
Over and above the basic contribution above, I/we 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/honored-donors 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:
IMPORTANT: THIS FORM DOES NOT MAKE YOUR PAYMENT.
After you click on SUBMIT button below, the data you entered above will be emailed to AHHA.
AND you will be transferred to the payment information screen.
Pick Option #1 to indicate you plan to mail a check or money order to AHHA to make your membership contribution.
Pick Option #2 to indicate you plan to use your credit card to make your membership contribution.