Individual Membership

Please use the form below to apply for membership in NHPHA. If you prefer to download our application and apply by mail, please visit our membership page.

When applying below, you may pay using PayPal or complete the application and mail in a check.

Individual Membership Application

Individual Membership Application *

Professional Annual Membership - $ 50.00

Three Year Professional Membership - $ 135.00

Lifetime Professional Membership - $ 500.00

Student Annual Membership - $ 15.00

Retiree Annual Membership - $ 25.00

Legislator Annual Membership - $ 25.00

Early-Career Professional - $ 25.00

Total Amount

Please enter a Username to create an account. If you, the primary contact, already have an account please login before completing this form.

Username *

Check Availability
Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores.

Password

Confirm Password

Provide a password for the new account in both fields.

Individual Member Details

First Name *

Last Name *

Email *

Primary Address *

City *

State *

Primary ZIP Code *

Home Zip Code *

Phone *

School Name

Program

Anticipated Graduation Date

Legislative District

Interested in joining a Committee or Section?

Graduation Date

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Contact

info@nhpha.org
4 Park Street
Suite 403
Concord, NH 03301
( p ) 603.228.2983

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