WHPRMS Member Application Form

Join the state's premier organization for health care marketing and public relations professionals today. If you are a new member, you will receive a membership packet as soon as your check is received and your membership is processed.

Email directly if you need to simply update your membership profile to reflect changes in your contact information or your position.

* Once you submit your application, you will be taken to a secured location via PayPal to pay for your WHPRMS membership. If you do not wish to pay electronically, you may send a check payable to WHPRMS to:

Beth Earnest, WHPRMS Membership Chair
2827 Coventry Lane
Waukesha, WI 53188

Personal Information

First Name:
Last Name:
Title:
Organization:
Mailing Address :
City:
County:
State:
Zip Code:
District (if known):
Telephone:
Fax:
E-mail:

As a member benefit, you can participate on committee work groups in areas that interest you. Check the areas below in which you would like further involvement. (optional)
	Communications Review Awards Program Participate in judging entries that come in for the awards program.
	Leadership Recognition Program Review and score applications received for the recognition program.
	Membership Recruitment and Retention Offer support in recruiting and retaining WHPRMS members.
	Mentorship Program Mentor entry-level marketing professionals in the organization.
Leadership Recognition - Level Attained: (select one)
	N/A
	Certified
	Accredited
	Fellow
Length of Membership: (select one)
	New
	1-2 Years
	3-5 Years
	6+ Years
Fees:
	Regular - $100 Membership for Healthcare Communicators
	Associate - $125 Membership for individuals or organizations providing services for healthcare communicators (i.e., agencies, vendors).
	Student - $25 Membership for students or interns pursuing a healthcare communications career.
Payment:
	By check *See Beth Earnest's info above
	Via PayPal (you will automatically be taken to PayPal when the application is submitted)

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