New Member Application
  • All fields marked with an asterisk (*) are required

First Name *
 M.I.
 Last Name *
Degree (use abbreviations only)
Position/Title
Organization
Work Phone
Home Phone
FAX Number
Email *
  

Preferred Mailing Address *
Home Business (Select One)		 APHA requests you use your home address so we can alert you to key votes being considered by the House Member and Senators who represent you.
Address 1 *
 Line 2
City *
 State or Province (USA and Canada)



Zip / Postal Code (Required for USA)
 Country (if not USA) *
If you are located outside of the USA, your publications will be sent via air mail. There is an additional charge of $40 to cover the cost.

CHECK
HERE		 MEMBERSHIP CATEGORY ANNUAL DUES
Regular
Includes all member benefits including online access and monthly print issues of The Nation’s Health and the American Journal of Public Health.		 $200.00
Special Health Worker
Persons employed in community health whose annual salary is less than $40,000 or the equivalent for foreign nationals. (Please send proof of status via fax (202) 777-2530 or email it to membership.mail@apha.org.) 		$75.00
Retired
APHA members who have retired from active public health practice and no longer derive significant income from work-related activities. (Retired members will receive a print copy of the American Journal of Public Health.) 		$85.00
Early Career Professional
Open to anyone who has graduated in the last 24 months. Proof of graduation is required. Designed for individuals who are transitioning into the workforce, Early Career Professional offers all the same benefits as Regular membership, including mailed print copies of The American Journal of Public Health and The Nation’s Health, in addition to programs specific to new public health professionals. This member type is available for three consecutive years. Please send proof of graduation via fax (202-777-2530) or email (membership.mail@apha.org). 		$115.00

Student
Persons enrolled full- or part-time (minimum of 6 credit hours) who are actively pursuing a degree. Proof of status is required. Students receive online access to The American Journal of Public Health and print/online access to The Nation’s Health in addition to becoming members of the Student Assembly. Please send proof of status via fax (202-777-2530) or email (membership.mail@apha.org).

As a Student member, you can purchase a print subscription to The American Journal of Public Health for an additional $30/year.
Check this box if you would like to purchase a print subscription to AJPH..

Post doctoral candidates and others who cannot meet the above requirements may be eligible for the Special Health Worker category.

 $75.00

For Students and Early Career Professionals only:
Students should enter anticipated graduation date. Early Career Professionals should enter actual graduation date.
College/University:
Graduation Date *: (MM/YYYY)
Degree
Program/Area of Study:


Section/SPIG -1 (Included):
Section/SPIG -2 ($30):
Section/SPIG -3 ($30):
Membership dues are not deductible as a charitable contribution but may be deductible as an ordinary and necessary business expense.
Membership is nontransferable and nonrefundable.
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