ASDAH: Join

ASDAH Membership Application

Individuals applying for membership agree to uphold the ASDAH Mission (view) and goals, and confirm their commitment to the Health At Every Size Principles^SM (view).

Membership Levels:
Full Membership - Dues $50 Open to any individual whose employment or volunteer work promotes or is moving toward the promotion of the Health At Every Size^SM Principles. This level has full voting privileges.
Associate Membership - Dues $35 Available to non-professionals and professionals in fields unrelated to size diversity and/or health, who are interested in these issues. This level does not have voting privileges.
Student Membership - Dues $20 Available to those interested in issues related to size diversity and health who show proof of full-time student status. This level does not have voting privileges.

The information that you provide on this membership application will be used only in our internal membership records and will be password-protected. To maximize the security of your account we ask that along with selecting a password you answer one of three "secret questions" as noted below.

A dues payment received now will validate your new membership until June 30, 2011.

Required *

Prefix

First Name*

Middle Initial

Last Name*

Membership Level*

Degrees

License/Certification

Occupation

Title/Organization

Address (mailing)*

Address (mailing - line 2)

City *

State/Province*

(Add Option = NonUs.
Canada = drop down)

Zip/Postal Code*

Country*

Phone (primary)*

(Please insert hyphens for all
phone #s, e.g. xxx-xxx-xxxx)

Phone (secondary)

Fax

Preferred Contact Method

Phone

Preferred Email Format

HTML

Text

E-Mail (login ID)*

Confirm E-Mail*

Password*

Confirm Password*

Secret Question*

Secret Answer*

Join the ASDAH member email list?

Yes

Website

How did you hear about ASDAH?

Other HAES Affiliations/Organizations
(e.g. NAAFA)

If you would like to make an additional donation to support the work of ASDAH (over and above your membership fee) please complete the following two items:

Donation Amount

Donation Fund

Donations to ASDAH support our effective and much-needed educational and advocacy efforts and are tremendously appreciated.

Note: ASDAH is a non-profit organization classified as 501 (c) (6). Contributions, gifts, and dues to ASDAH are not tax deductible. ASDAH donations & dues may be deductible as business expenses -- please consult your tax professional.

Comments/Questions

CAUTION: Please make sure this form is complete and accurate before selecting your payment option. Once you have clicked on Pay Online or Pay by Mail attempting to click your browser BACK button will result in an application error.

Note: ASDAH's Membership year is July 1 through June 30.

The Association for Size Diversity and Health welcomes people of all sizes and shapes regardless of race, color, national origin, religion, creed, gender, age, marital status, sexual/affectional orientation, mental or physical disability, or veteran status.