ALQHA Membership Form

ALQHA Premium Membership Application

To apply for membership please complete all questions.
Click here for printable membership form.

No convenience fees added for mail-in memberships.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

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Zip Code
E-mail*
Home Number

Area CodePhone Number
Cellular Number

Area CodePhone Number
Website
Birthdate (for Youth)

MonthDayYear
My Products
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Lifetime Membership$210.00
ALQHA Open Lifetime Membership - Includes convenience fee.

Open Membership - 1 Year$30.00
ALQHA Open Membership - Includes convenience fee

Amateur Membership - 1 Year$50.00
ALQHA/ALAQHA Open/Amateur Membership - Includes convenience fee

Youth Membership - Lifetime$55.00
ALQHYA Youth Lifetime Membership -Includes convenience fee

Youth Membership - 1 Year$20.00
ALQHA Youth Membership -Includes convenience fee**Add the Open membership if you want to be eligible for Open awards
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ALQHA Premium Membership Application