Thank you for your support of WiHPCA! Please complete the associate membership application thoroughly. A benefit to the associate membership is you may include an unlimited number of employees and/or staff. These individuals will have access to all of WiHPCA's benefits when they are included with your organization. WiHPCA associate member annual dues are $500/year. Once we receive your application, you will receive a dues invoice via email. Please include your organization's current logo, a brief description of your organization, and the best contact information to be listed on our website.
Street Address Line 2
State / Province
Postal / Zip Code
Briefly describe your organization
JPG or PNG files
Best contact for you organization (to be listed on our website)
Employees you would like added to your WiHPCA associate membership. Please include full name, position and email address.
Should be Empty: