IAWHP Membership Application
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IAWHP Professional Membership - $55.00
IAWHP Student Member - $25.00
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Contact Information
Email
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First Name
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AB - Alberta
ACT - Australian Captial Territory
AGS - Aguascalientes
AK - Alaska
AL - Alabama
AR - Arkansas
AZ - Arizona
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BCN - Baja California Norte
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CA - California
CAM - Campeche
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CO - Colorado
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CT - Connecticut
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DE - Delaware
DF - Distrito Federal
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MD - Maryland
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MI - Michigan
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MS - Mississippi
MT - Montana
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NC - North Carolina
ND - North Dakota
NE - Nebraska
NF - Newfoundland
NH - New Hampshire
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NL - Nuevo Leon
NM - New Mexico
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NT - Northern Territory
NV - Nevada
NY - New York
OAX - Oaxaca
OH - Ohio
OK - Oklahoma
ON - Ontario
OR - Oregon
PA - Pennsylvania
PE - Prince Edward Island
PQ - Quebec
PR - Puerto Rico
PUE - Puebla
QLD - Queensland
QRO - Queretaro
QROO - Quintana Roo
RI - Rhode Island
SA - South Australia
SC - South Carolina
SD - South Dakota
SIN - Sinaloa
SK - Saskatchewan
SLP - San Luis Potosi
SON - Sonora
TAB - Tabasco
TAMPS - Tamaulipas
TAS - Tasmania
TLAX - Tlaxcala
TN - Tennessee
TX - Texas
UT - Utah
VA - Virginia
VER - Veracruz
VIC - Victoria
VT - Vermont
WA - Washington
WI - Wisconsin
WV - West Virginia
WY - Wyoming
YUC - Yucatan
ZAC - Zacatecas
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Website
Phone Number
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Fax Number
Alternate Email
Include me in Membership Directories
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Include me in Broadcast Email
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Additional Information
Additional Information
Please select your gender.
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What is your race/ethnicity? (optional)
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Are you an ACSM Member?
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What is your highest degree earned?
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What professional certifications do you have? (To select more than one use CTRL and Click)
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ACSM
ACE
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SHRM
National Commission for Health Education Credentialing
American Diabetes Association
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Other
How many years have you worked in the field?
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<3
3-5
6-10
10-20
>20
What is your current work setting?
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Community
Corporate <500 employees
Corporate 501-1000 employees
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Corporate >10000 employees
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The organization that provides my work setting
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If you work in a corporate setting- How many sites do you serve?
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Single site
2-10 sites
>10 sites
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What is your interest in organization involvement? (To select more than one use CTRL and Click)
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Online & Print Publications
Webinar Series Presenter
Communication Committee
Education Committee
Finance Committe
International Committee
Membership Committee
Strategic Projects Committee
Student Committee
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I have read the
IAWHP Code of Ethics
and agree to abide by it.
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If applying as a student member- I attest that I am currently enrolled at least half-time as a student.
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Payment Details
Payment Details
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savings
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