Affiliate Sign Up
Please type in your organization's information. A Regular Affiliate account allows for one individual membership under your organization. A Sustaining Affiliate account allows all employees to become individual members and gain the benefits of an IPHA membership.
Registration fees can be paid via credit card. Payments made by credit card will include a 3.5% processing fee. This fee is charged to cover the processing costs associated with credit card payments.
Your membership will be valid from to
After submission you will receive an invoice email from our payment provider. To complete your registration you will need to either pay the invoice online or send us a check. If Credit Card was selected above you will also be shown a link in the success message which you can use to pay immediately if you choose.