GHEC Individual Membership Application
 (12 Month Rolling Renewal)

  
 
Individual Membership: $100 USD

 
 


Notes about E-mail and the Listserv:

Be sure to include your e-mail address, if you have one. The GHEC Listserv is a very useful tool for communication among members, and a way for the Secretariat to send out announcements and other timely items to all members.

E-mail address will be included in a list provided the GHEC member who manages our listerv of GHEC members. E-mail addresses will not be provided to any other organization. If you do not want your e-mail address added to the listserv, please indicate this in the provided space next to your e-mail name.

 
 
Name:
 
Phone:
Title:
Fax:
University or Other Affiliation:
 
Department:
Mailing Address:
City:
State:
Zip:
E-mail Address:
  
_____ I do not want to be added
to the GHEC Listserv
 
 

Please make checks payable to GHEC, and send to:

GHEC Secretariat
305 West Broadway, #332
New York, NY 10013

Please enclose this form with your payment

Our Federal Tax ID# is: 94-3175750

Questions about dues should be directed to: info@ihmec.org
 or by phone: (646) 831-3220, fax: (646) 839-2707

  
     
copyright 2005 Global Health Education Consortium