Use this form to join or renew your membership in the Pacific Northwest Chapter of the Society for Public Health Education for 2013.
Fill out the fields below and pay online at www.pnwsophe.org, or send check to:
PNW SOPHE, P.O. Box 2755, Seattle, WA 98111.

* 1. Member Information

* 2. Are you a new member or renewing member?

* 3. Degree(s)

* 4. Are you a CHES/MCHES?

* 5. Are you a National SOPHE member?

* 6. Job Title

* 7. Work Responsibilities

* 8. Expertise I Can Offer

* 9. I am interested in helping the chapter with:

* 10. Type of Payment

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