Membership Application Form Thank you for your interest in becoming a member of the Canadian Women’s Heart Health Alliance. Question Title * 1. Personal information Name: Organization (If Applicable): City: Province: Mailing Address: Email Address Phone Number: Twitter Handle (If Applicable): Admin Assistant (If Applicable): Name: Email: Phone Number: Question Title * 2. Please select which category you would best fall in: Woman with lived experience Clinical trainee Research trainee Clinician Researcher Clinician scientist Other (please specify) Next
