Associate Membership Application

I understand that submission of this application is not a guarantee of IHCA membership and that this application must be approved by the IHCA Board of Directors. Approval of membership does not constitute endorsement by the IHCA of applicant or its products and/or services. I understand that membership benefits are only to be used by the applicant and its employees and that any misuse of membership rights and benefits may result in membership termination. If this application is approved, IHCA may use applicant’s information in IHCA electronic membership directory, and applicant consents to receive communications via regular mail, email, telephone, and/or fax sent by or on behalf of IHCA. Payment of Associate Member Dues must accompany this application and will be processed upon receipt. Payment will be refunded if membership is denied.