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Registration

Cost of Membership

  • Individual Member $40
    for individuals working in, or interested in public health
  • Affiliate Member $30
    for individuals who are a member of a CPHA affiliate (CO-SOPHE, PHNAC, or CMHF)

  • Student or Retiree Member $15
    for full-time students, those earning less than $12,000/year, or retired individuals

Membership Form

Salutation
First Name
Last Name
Organization
Address
Address 2
City
State
Zip
Phone (xxx-xxx-xxxx)
Extension
Email
  Note: This is where CPHA member notices and legislative alerts will be sent
Is this a work or home address?
Home Address Office Address
Membership Type (See descriptions above)


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