The Maine Public Health Association

SAVE THE DATE

October 22, 2013 - MPHA's 29th Fall Conference

BECOME A MEMBER

If you would like to become a member of MPHA, please click here for a PDF copy of MPHA's membership enrollment form or fill out the form below.

2014 Online Membership Form - October 1, 2013 - September 30, 2014

PLEASE MAKE SURE TO FILL OUT ENTIRE FORM.

ANNUAL MEMBERSHIP CATEGORIES

YOUR INVOLVEMENT

	Individual Memberships:
	Lifetime Membership - $750 • One Individual membership for life • Includes all member benefits plus a 20% discount on all MPHA events

	Individual - $60 • One 2014 individual membership

	Retiree - $25

	Full-time Student - $10 • Qualification for student rate is 12 credit hours or more School name:

	Corporate Memberships:
	Sustaining Organization - $5,000 • Up to 20 Individual 2014 memberships • 10 Fall Conference registrations • Platinum level Fall Conference sponsorship (over a $3,000 value) • Your logo on MPHA website

	Alliance Organization - $2,500 • Up to 15 Individual 2014 memberships • Your logo on MPHA website • Gold level Fall Conference sponsorship (over a $2,000 value)

	Advocate Organization - $1,000 • Up to 10 Individual 2014 memberships • Your logo on MPHA website

	Partner Organization - $500 • Up to 5 Individual 2014 memberships

	Additional Support:
	I would like to further support the work of MPHA: please accept my additional contribution of $ to advance public health in Maine.

MPHA is only as strong as its membership. Please partner with us to help make Maine a healthy place to live.


	Contribute to the E-newsletter on a topic of my expertise:

	Serve on one of the following MPHA Committees: Marketing/Membership Tobacco Policy Obesity Policy Broad public health policy Conference planning Awards/nominations

	Represent MPHA on an external Board or Committee

	Help to plan an MPHA regional meeting

	Other:

*Make sure all your communications from The Maine Public Health Association are reaching you.
Add The Maine Public Health Association (mainepublichealth.org) to your trusted e-mail sender list.

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MPHA is an affiliate of the American Public Health Association,
for more information about APHA, go to www.apha.org.

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