{"id":871,"date":"2021-07-18T23:13:38","date_gmt":"2021-07-19T03:13:38","guid":{"rendered":"https:\/\/cneha.org\/community\/?page_id=871"},"modified":"2025-09-03T10:54:28","modified_gmt":"2025-09-03T14:54:28","slug":"membership-form","status":"publish","type":"page","link":"https:\/\/cneha.org\/community\/membership-form\/","title":{"rendered":"Membership Registration Form"},"content":{"rendered":"<h1>Online Membership Form<\/h1>\n<p>You can now purchase memberships using PayPal. After submitting the form you will be directed to PayPal to complete the application.<\/p>\n<p>Please include your email where you would like to receive the newsletter, since we are moving to an electronic only version! (See below)<\/p>\n<p>The October 2015 Newsletter (No. 92) will be the last printed edition. In an effort to maintain current membership rates, the Board has voted to transition all subsequent newsletters to an electronic format that will be sent to all members via email.<\/p>\n<p>Le bulletin (no. 92), celui du mois d\u2019octobre dernier, aura \u00e9t\u00e9 le dernier num\u00e9ro imprim\u00e9. Afin de maintenir les taux d\u2019abonnements actuels, l\u2019ex\u00e9cutif a vot\u00e9 en faveur d\u2019un format \u00e9lectronique pour les bulletins. Tous les bulletins seront donc envoy\u00e9s aux membres par courriel \u00e0 l\u2019avenir.<\/p>\n<div style=\"display:none\" class=\"fm-form-container fm-theme1\"><div id=\"fm-pages26\" class=\"fm-pages wdform_page_navigation \" show_title=\"\" show_numbers=\"1\" type=\"none\"><\/div><form name=\"form26\" action=\"\/community\/wp-json\/wp\/v2\/pages\/871\" method=\"post\" id=\"form26\" class=\"fm-form form26  \" enctype=\"multipart\/form-data\"><input type=\"hidden\" id=\"counter26\" value=\"33\" name=\"counter26\" \/><input type=\"hidden\" id=\"Itemid26\" value=\"\" name=\"Itemid26\" \/><input type=\"hidden\" id=\"fm_shake26\" value=\"1\" name=\"fm_shake26\" \/><input type=\"text\" class=\"fm-hide\" id=\"fm_empty_field_validation26\" value=\"\" name=\"fm_empty_field_validation26\" data-value=\"bd736efb144d599cf463541431fbf5c4\" \/><div class=\"wdform-page-and-images fm-form-builder\"><div id=\"26form_view1\" class=\"wdform_page\" page_title=\"Untitled page\" next_title=\"Next\" next_type=\"text\" next_class=\"wdform-page-button\" next_checkable=\"true\" previous_title=\"Previous\" previous_type=\"text\" previous_class=\"wdform-page-button\" previous_checkable=\"false\"><div class=\"wdform_section\"><div class=\"wdform_column\"><div wdid=\"2\" class=\"wdform_row\"><div type=\"type_text\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_text\" ><div class=\"wdform-label-section wd-width-100  wd-flex-row wd-align-items-center\">    <label  for=\"wdform_2_element26\" class=\"wdform-label\">First Name<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-align-items-center wd-width-100\" ><input type=\"text\"                           class=\"wd-width-100\"                           id=\"wdform_2_element26\"                           name=\"wdform_2_element26\"                           value=\"\"                           title=\"\"                           placeholder=\"\"                                                       \/><\/div><\/div><\/div><div wdid=\"3\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_text\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_text\" ><div class=\"wdform-label-section wd-width-100  wd-flex-row wd-align-items-center\">    <label  for=\"wdform_3_element26\" class=\"wdform-label\">Last Name<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-align-items-center wd-width-100\" ><input type=\"text\"                           class=\"wd-width-100\"                           id=\"wdform_3_element26\"                           name=\"wdform_3_element26\"                           value=\"\"                           title=\"\"                           placeholder=\"\"                                                       \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"4\" class=\"wdform_row\"><div type=\"type_submitter_mail\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_submitter_mail\" ><div class=\"wdform-label-section wd-width-100  wd-flex-row\">    <label  for=\"wdform_4_element26\" class=\"wdform-label\">Email<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-width-100\" ><input type=\"text\" class=\"wd-width-100\" id=\"wdform_4_element26\" name=\"wdform_4_element26\" value=\"\" title=\"\" placeholder=\"\"   onchange=\"wd_check_email('4', '26', 'This is not a valid email address.')\" \/><\/div><\/div><\/div><div wdid=\"28\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_phone_new\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_phone_new\" ><div class=\"wdform-label-section wd-width-100 \">    <label  for=\"wdform_28_element26\" class=\"wdform-label\">Phone<\/label><\/div><div class=\"wdform-element-section wd-flex  wd-width-100\" ><input type=\"text\"                       class=\"wd-width-100\"                       id=\"wdform_28_element26\"                       name=\"wdform_28_element26\"                       value=\"\"                       placeholder=\"\"  \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"7\" class=\"wdform_row\"><div type=\"type_address\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_address\" ><div class=\"wdform-label-section wd-width-100 wdform_address wd-flex-column\">    <label  for=\"wdform_7_street126\" class=\"wdform-label\">Address<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex wdform_address wd-flex-column wd-width-100\" ><span class=\"wd-width-100 wd-address\" id=\"wdform_7_address_0\">                <input class=\"wd-width-100 wdform_7_address_0\" type=\"text\" id=\"wdform_7_street126\" name=\"wdform_7_street126\" value=\"\"  \/>                <label for=\"wdform_7_street126\" class=\"mini_label\">Street Address<\/label><\/span><span class=\"wd-width-100 wd-address\" id=\"wdform_7_address_1\">                <input class=\"wd-width-100 wdform_7_address_1\" type=\"text\" id=\"wdform_7_street226\" name=\"wdform_8_street226\" value=\"\"  \/>                <label for=\"wdform_7_street226\" class=\"mini_label\">Street Address Line 2<\/label><\/span><span class=\"wd-width-100 wd-flex wd-flex-row wd-flex-wrap wd-justify-content\"><span class=\"wd-width-49 wd-address\" id=\"wdform_7_address_2\">                <input class=\"wd-width-100 wdform_7_address_2\" type=\"text\" id=\"wdform_7_city26\" name=\"wdform_9_city26\" value=\"\"  \/>                <label for=\"wdform_7_city26\" class=\"mini_label\">City<\/label><\/span><span class=\"wd-width-49 wd-address\" id=\"wdform_7_address_3\">                <input class=\"wd-width-100 wdform_7_address_3\" type=\"text\" id=\"wdform_7_state26\" name=\"wdform_10_state26\" value=\"\"  \/>                <label for=\"wdform_7_state26\" class=\"mini_label\">State \/ Province \/ Region<\/label><\/span><span class=\"wd-width-49 wd-address\" id=\"wdform_7_address_4\">              <input class=\"wd-width-100 wdform_7_address_4\" type=\"text\" id=\"wdform_7_postal26\" name=\"wdform_11_postal26\" value=\"\"  \/>              <label for=\"wdform_7_postal26\" class=\"mini_label\">Postal \/ Zip Code<\/label><\/span><span class=\"wd-width-49 wd-address\" id=\"wdform_7_address_5\">              <select class=\"wd-width-100 wdform_7_address_5\"                      type=\"text\"                      id=\"wdform_7_country26\"                      name=\"wdform_12_country26\"                                            ><option value=\"\" selected=\"selected\"><\/option><option value=\"Afghanistan\" >Afghanistan<\/option><option value=\"Albania\" >Albania<\/option><option value=\"Algeria\" >Algeria<\/option><option value=\"Andorra\" >Andorra<\/option><option value=\"Angola\" >Angola<\/option><option value=\"Antigua and Barbuda\" >Antigua and Barbuda<\/option><option value=\"Argentina\" >Argentina<\/option><option value=\"Armenia\" >Armenia<\/option><option value=\"Australia\" >Australia<\/option><option value=\"Austria\" >Austria<\/option><option value=\"Azerbaijan\" >Azerbaijan<\/option><option value=\"Bahamas\" >Bahamas<\/option><option value=\"Bahrain\" >Bahrain<\/option><option value=\"Bangladesh\" >Bangladesh<\/option><option value=\"Barbados\" >Barbados<\/option><option value=\"Belarus\" >Belarus<\/option><option value=\"Belgium\" >Belgium<\/option><option value=\"Belize\" >Belize<\/option><option value=\"Benin\" >Benin<\/option><option value=\"Bhutan\" >Bhutan<\/option><option value=\"Bolivia\" >Bolivia<\/option><option value=\"Bosnia and Herzegovina\" >Bosnia and Herzegovina<\/option><option value=\"Botswana\" >Botswana<\/option><option value=\"Brazil\" >Brazil<\/option><option value=\"Brunei\" >Brunei<\/option><option value=\"Bulgaria\" >Bulgaria<\/option><option value=\"Burkina\" >Burkina Faso<\/option><option value=\"Burundi\" >Burundi<\/option><option value=\"Cambodia\" >Cambodia<\/option><option value=\"Cameroon\" >Cameroon<\/option><option value=\"Canada\" >Canada<\/option><option value=\"Cape Verde\" >Cape Verde<\/option><option value=\"Central African Republic\" >Central African Republic<\/option><option value=\"Chad\" >Chad<\/option><option value=\"Chile\" >Chile<\/option><option value=\"China\" >China<\/option><option value=\"Colombia\" >Colombia<\/option><option value=\"Comoros\" >Comoros<\/option><option value=\"Congo\" >Congo<\/option><option value=\"Congo (Brazzaville)\" >Congo (Brazzaville)<\/option><option value=\"Costa Rica\" >Costa Rica<\/option><option value=\"Cote d'Ivoire\" >Cote d'Ivoire<\/option><option value=\"Croatia\" >Croatia<\/option><option value=\"Cuba\" >Cuba<\/option><option value=\"Curacao\" >Curacao<\/option><option value=\"Cyprus\" >Cyprus<\/option><option value=\"Czech Republic\" >Czech Republic<\/option><option value=\"Denmark\" >Denmark<\/option><option value=\"Djibouti\" >Djibouti<\/option><option value=\"Dominica\" >Dominica<\/option><option value=\"Dominican Republic\" >Dominican Republic<\/option><option value=\"East Timor (Timor Timur\" >East Timor (Timor Timur)<\/option><option value=\"Ecuador\" >Ecuador<\/option><option value=\"Egypt\" >Egypt<\/option><option value=\"El Salvador\" >El Salvador<\/option><option value=\"Equatorial\" >Equatorial Guinea<\/option><option value=\"Eritrea\" >Eritrea<\/option><option value=\"Estonia\" >Estonia<\/option><option value=\"Eswatini\" >Eswatini<\/option><option value=\"Ethiopia\" >Ethiopia<\/option><option value=\"Fiji\" >Fiji<\/option><option value=\"Finland\" >Finland<\/option><option value=\"France\" >France<\/option><option value=\"Gabon\" >Gabon<\/option><option value=\"Gambia, The\" >Gambia, The<\/option><option value=\"Georgia\" >Georgia<\/option><option value=\"Germany\" >Germany<\/option><option value=\"Ghana\" >Ghana<\/option><option value=\"Greece\" >Greece<\/option><option value=\"Grenada\" >Grenada<\/option><option value=\"Guatemala\" >Guatemala<\/option><option value=\"Guinea\" >Guinea<\/option><option value=\"Guinea-Bissau\" >Guinea-Bissau<\/option><option value=\"Guyana\" >Guyana<\/option><option value=\"Haiti\" >Haiti<\/option><option value=\"Honduras\" >Honduras<\/option><option value=\"Hong Kong\" >Hong Kong<\/option><option value=\"Hungary\" >Hungary<\/option><option value=\"Iceland\" >Iceland<\/option><option value=\"India\" >India<\/option><option value=\"Indonesia\" >Indonesia<\/option><option value=\"Iran\" >Iran<\/option><option value=\"Iraq\" >Iraq<\/option><option value=\"Ireland\" >Ireland<\/option><option value=\"Israel\" >Israel<\/option><option value=\"Italy\" >Italy<\/option><option value=\"Jamaica\" >Jamaica<\/option><option value=\"Japan\" >Japan<\/option><option value=\"Jordan\" >Jordan<\/option><option value=\"Kazakhstan\" >Kazakhstan<\/option><option value=\"Kenya\" >Kenya<\/option><option value=\"Kiribati\" >Kiribati<\/option><option value=\"Korea, North\" >Korea, North<\/option><option value=\"Korea, South\" >Korea, South<\/option><option value=\"Kuwait\" >Kuwait<\/option><option value=\"Kyrgyzstan\" >Kyrgyzstan<\/option><option value=\"Laos\" >Laos<\/option><option value=\"Latvia\" >Latvia<\/option><option value=\"Lebanon\" >Lebanon<\/option><option value=\"Lesotho\" >Lesotho<\/option><option value=\"Liberia\" >Liberia<\/option><option value=\"Libya\" >Libya<\/option><option value=\"Liechtenstein\" >Liechtenstein<\/option><option value=\"Lithuania\" >Lithuania<\/option><option value=\"Luxembourg\" >Luxembourg<\/option><option value=\"Madagascar\" >Madagascar<\/option><option value=\"Malawi\" >Malawi<\/option><option value=\"Malaysia\" >Malaysia<\/option><option value=\"Maldives\" >Maldives<\/option><option value=\"Mali\" >Mali<\/option><option value=\"Malta\" >Malta<\/option><option value=\"Marshall Islands\" >Marshall Islands<\/option><option value=\"Mauritania\" >Mauritania<\/option><option value=\"Mauritius\" >Mauritius<\/option><option value=\"Mexico\" >Mexico<\/option><option value=\"Micronesia\" >Micronesia<\/option><option value=\"Moldova\" >Moldova<\/option><option value=\"Monaco\" >Monaco<\/option><option value=\"Mongolia\" >Mongolia<\/option><option value=\"Montenegro\" >Montenegro<\/option><option value=\"Morocco\" >Morocco<\/option><option value=\"Mozambique\" >Mozambique<\/option><option value=\"Myanmar\" >Myanmar<\/option><option value=\"Namibia\" >Namibia<\/option><option value=\"Nauru\" >Nauru<\/option><option value=\"Nepal\" >Nepal<\/option><option value=\"Netherlands\" >Netherlands<\/option><option value=\"New Zealand\" >New Zealand<\/option><option value=\"Nicaragua\" >Nicaragua<\/option><option value=\"Niger\" >Niger<\/option><option value=\"Nigeria\" >Nigeria<\/option><option value=\"North Macedonia\" >North Macedonia<\/option><option value=\"Norway\" >Norway<\/option><option value=\"Oman\" >Oman<\/option><option value=\"Pakistan\" >Pakistan<\/option><option value=\"Palau\" >Palau<\/option><option value=\"Palestine\" >Palestine<\/option><option value=\"Panama\" >Panama<\/option><option value=\"Papua New Guinea\" >Papua New Guinea<\/option><option value=\"Paraguay\" >Paraguay<\/option><option value=\"Peru\" >Peru<\/option><option value=\"Philippines\" >Philippines<\/option><option value=\"Poland\" >Poland<\/option><option value=\"Portugal\" >Portugal<\/option><option value=\"Puerto Rico\" >Puerto Rico<\/option><option value=\"Qatar\" >Qatar<\/option><option value=\"Romania\" >Romania<\/option><option value=\"Russia\" >Russia<\/option><option value=\"Rwanda\" >Rwanda<\/option><option value=\"Saint Kitts and Nevis\" >Saint Kitts and Nevis<\/option><option value=\"Saint Lucia\" >Saint Lucia<\/option><option value=\"Saint Vincent\" >Saint Vincent<\/option><option value=\"Samoa\" >Samoa<\/option><option value=\"San Marino\" >San Marino<\/option><option value=\"Sao Tome and Principe\" >Sao Tome and Principe<\/option><option value=\"Saudi Arabia\" >Saudi Arabia<\/option><option value=\"Senegal\" >Senegal<\/option><option value=\"Serbia\" >Serbia<\/option><option value=\"Seychelles\" >Seychelles<\/option><option value=\"Sierra Leone\" >Sierra Leone<\/option><option value=\"Singapore\" >Singapore<\/option><option value=\"Slovakia\" >Slovakia<\/option><option value=\"Slovenia\" >Slovenia<\/option><option value=\"Solomon Islands\" >Solomon Islands<\/option><option value=\"Somalia\" >Somalia<\/option><option value=\"South Africa\" >South Africa<\/option><option value=\"South Sudan\" >South Sudan<\/option><option value=\"Spain\" >Spain<\/option><option value=\"Sri Lanka\" >Sri Lanka<\/option><option value=\"Sudan\" >Sudan<\/option><option value=\"Suriname\" >Suriname<\/option><option value=\"Sweden\" >Sweden<\/option><option value=\"Switzerland\" >Switzerland<\/option><option value=\"Syria\" >Syria<\/option><option value=\"Taiwan\" >Taiwan<\/option><option value=\"Tajikistan\" >Tajikistan<\/option><option value=\"Tanzania\" >Tanzania<\/option><option value=\"Thailand\" >Thailand<\/option><option value=\"Togo\" >Togo<\/option><option value=\"Tonga\" >Tonga<\/option><option value=\"Trinidad and Tobago\" >Trinidad and Tobago<\/option><option value=\"Tunisia\" >Tunisia<\/option><option value=\"Turkey\" >Turkey<\/option><option value=\"Turkmenistan\" >Turkmenistan<\/option><option value=\"Tuvalu\" >Tuvalu<\/option><option value=\"Uganda\" >Uganda<\/option><option value=\"Ukraine\" >Ukraine<\/option><option value=\"United Arab Emirates\" >United Arab Emirates<\/option><option value=\"United Kingdom\" >United Kingdom<\/option><option value=\"United States\" >United States<\/option><option value=\"Uruguay\" >Uruguay<\/option><option value=\"Uzbekistan\" >Uzbekistan<\/option><option value=\"Vanuatu\" >Vanuatu<\/option><option value=\"Vatican City\" >Vatican City<\/option><option value=\"Venezuela\" >Venezuela<\/option><option value=\"Vietnam\" >Vietnam<\/option><option value=\"Wales\" >Wales<\/option><option value=\"Yemen\" >Yemen<\/option><option value=\"Zambia\" >Zambia<\/option><option value=\"Zimbabwe\" >Zimbabwe<\/option><\/select>              <label for=\"wdform_7_country26\" class=\"mini_label\">Country<\/label><\/span><\/span><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"29\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_name\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_name\" ><div class=\"wdform-label-section wd-width-100  wd-flex-row\">    <label  for=\"wdform_29_element_first26\" class=\"wdform-label\">2nd Name for Joint Membership<\/label><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-width-100\" ><div class=\"wd-flex wd-flex-column wd-width-50\"><input type=\"text\" class=\"wd-width-100\" id=\"wdform_29_element_first26\" name=\"wdform_29_element_first26\" value=\"\" title=\"\" placeholder=\"\"  \/><label class=\"mini_label\" for=\"wdform_29_element_first26\">First<\/label><\/div><div class=\"wd-flex wd-flex-column wd-name-separator\"><\/div><div class=\"wd-flex wd-flex-column wd-width-50\"><input type=\"text\" class=\"wd-width-100\" id=\"wdform_29_element_last26\" name=\"wdform_29_element_last26\" value=\"\" title=\"\" placeholder=\"\"  \/><label class=\"mini_label\" for=\"wdform_29_element_last26\">Last<\/label><\/div><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"13\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_text\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_text\" ><div class=\"wdform-label-section wd-width-100  wd-flex-row wd-align-items-center\">    <label  for=\"wdform_13_element26\" class=\"wdform-label\">Name of Person\/Organization Paying if Other than Yourself:<\/label><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-align-items-center wd-width-100\" ><input type=\"text\"                           class=\"wd-width-100\"                           id=\"wdform_13_element26\"                           name=\"wdform_13_element26\"                           value=\"\"                           title=\"\"                           placeholder=\"\"                                                       \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"30\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_radio\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_radio\" ><div class=\"wdform-label-section wd-width-100  wd-flex-wrap wd-flex-column\">    <label  class=\"wdform-label\">Permission to publish E-Mail address in Newsletter\/ Permission de publier l\u2019adresse \u00e9lectronique en Bulletin<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-wrap wd-flex-column wd-width-100\" ><div class=\"wd-flex wd-flex-column\"><input type=\"hidden\" name=\"wdform_30_element26\" value=\"\" \/><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\"  id=\"wdform_30_element260\" name=\"wdform_30_element26\" value=\"Yes \/ Oui\" onclick=\"set_default(&quot;wdform_30&quot;,&quot;0&quot;,&quot;26&quot;); \"   \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_30_element260\"><span><\/span>Yes \/ Oui<\/label><\/div><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\"  id=\"wdform_30_element261\" name=\"wdform_30_element26\" value=\"No \/ Non\" onclick=\"set_default(&quot;wdform_30&quot;,&quot;1&quot;,&quot;26&quot;); \"   \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_30_element261\"><span><\/span>No \/ Non<\/label><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"32\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_paypal_radio\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_paypal_radio\" ><div class=\"wdform-label-section wd-width-100  wd-flex-column\">    <label  class=\"wdform-label\">Membership Options<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-column wd-width-100\" ><div class=\"wd-flex-wrap wd-flex wd-flex-column\"><input type=\"hidden\" name=\"wdform_32_element26\" value=\"\" \/><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\" id=\"wdform_32_element260\" name=\"wdform_32_element26\" value=\"40\" title=\"Individual \/ ordinaire - $40\"   \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_32_element260\"><span><\/span>Individual \/ ordinaire - $40<\/label><\/div><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\" id=\"wdform_32_element261\" name=\"wdform_32_element26\" value=\"25\" title=\"Student (1) \/ \u00e9tudiant (1) - $25\"   \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_32_element261\"><span><\/span>Student (1) \/ \u00e9tudiant (1) - $25<\/label><\/div><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\" id=\"wdform_32_element262\" name=\"wdform_32_element26\" value=\"$25\" title=\"Green Student (2) \/ etudiant (2) - $25\"   \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_32_element262\"><span><\/span>Green Student (2) \/ etudiant (2) - $25<\/label><\/div><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\" id=\"wdform_32_element263\" name=\"wdform_32_element26\" value=\"35\" title=\"Retired \/ retrait\u00e9 - $35\"   \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_32_element263\"><span><\/span>Retired \/ retrait\u00e9 - $35<\/label><\/div><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\" id=\"wdform_32_element264\" name=\"wdform_32_element26\" value=\"45\" title=\"Joint (3) \/ conjoint (3) - $45\"   \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_32_element264\"><span><\/span>Joint (3) \/ conjoint (3) - $45<\/label><\/div><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\" id=\"wdform_32_element265\" name=\"wdform_32_element26\" value=\"55\" title=\"Fellow (4) \/ associ\u00e9 (4) - $55\"   \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_32_element265\"><span><\/span>Fellow (4) \/ associ\u00e9 (4) - $55<\/label><\/div><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\" id=\"wdform_32_element266\" name=\"wdform_32_element26\" value=\"600\" title=\" Life \/ \u00e0 vie - $600\"   \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_32_element266\"><span><\/span> Life \/ \u00e0 vie - $600<\/label><\/div><div class=\"radio-div wd-choice wd-flex wd-flex-row\"><input type=\"radio\" id=\"wdform_32_element267\" name=\"wdform_32_element26\" value=\"55\" title=\"Business \/ entreprise \/ Institution \/ Institution - $55\"   \/><label class=\"wd-align-items-center wd-flex wd-flex-row\" for=\"wdform_32_element267\"><span><\/span>Business \/ entreprise \/ Institution \/ Institution - $55<\/label><\/div><\/div><div id=\"wdform_32_div26\" class=\"wd-flex wd-flex-row wd-align-items-center\"><\/div><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"16\" class=\"wdform_row\"><div type=\"type_file_upload\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_file_upload\" ><div class=\"wdform-label-section wd-width-100  wd-flex-column\">    <label  for=\"wdform_16_element26\" class=\"wdform-label\">Upload Copy of Student ID* if applicable <\/label><\/div><div class=\"wdform-element-section wd-flex  wd-flex-column wd-width-100\" ><label class=\"file-upload\"><div class=\"file-picker\"><\/div><input type=\"file\" id=\"wdform_16_element26\" name=\"wdform_16_file26[]\"   \/><\/label><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"19\" class=\"wdform_row\"><div type=\"type_editor\" class=\"wdform-field\"><p style=\"color: rgb(85, 85, 85); font-family: \"Lucida Grande\", sans-serif; font-size: 14px; text-align: center;\"><span style=\"font-size: medium;\"><em>By clicking the \"Submit Application\" button you are submiting your online application and will be re-directed to Paypal to submit your payment.\u00a0You will receive an email confirming your membership submission following payment.<\/em><\/span><\/p><p style=\"color: rgb(85, 85, 85); font-family: \"Lucida Grande\", sans-serif; font-size: 14px; text-align: center;\"><em><span style=\"font-size: medium;\">Thank you!<\/span><\/em><\/p><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"1\" class=\"wdform_row\"><div type=\"type_submit_reset\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_submit_reset\" ><div class=\"wdform-element-section wd-flex  wd-flex-row wd-justify-content-left wd-width-100\" ><button  type=\"button\" class=\"button-submit\" onclick=\"fm_submit_form('26');\"  data-ajax=\"0\"><span class=\"fm-submit-loading spinner fm-ico-spinner\"><\/span>Submit<\/button><button  type=\"button\" class=\"button-reset wd-hidden\" onclick=\"fm_reset_form(26);\" >Reset<\/button><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"23\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_editor\" class=\"wdform-field\"><p style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\" data-mce-style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\">(1) Must send copy of current student I.D.<br><\/p><p style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\" data-mce-style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\">(1) Veuillez inclure une preuve de statut d\u2019\u00e9tudiant pour l\u2019ann\u00e9e courante.<\/p><p style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\" data-mce-style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\">(2) All benefits of a regular membership, with a PDF-only version of the journal (no printedversion).<\/p><p style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\" data-mce-style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\">(2) Tous les b\u00e9n\u00e9fices d\u2019un membre r\u00e9gulier, avec une version PDF de la revue seulement(aucune version imprim\u00e9e).<br><\/p><p style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\" data-mce-style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\">(3) For two people at the same mailing address receiving only one copy of publications.<\/p><p style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\" data-mce-style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\">(3) Pour deux personnes r\u00e9sidant \u00e0 la m\u00eame adresse postale \u2013 elles ne re\u00e7oivent qu\u2019un seulexemplaire des publications.<\/p><p style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\" data-mce-style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\">(4) For those who feel a primary commitment to Northeast Historical Archaeology andwish to support the work of the Council at a higher membership rate.<\/p><p style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\" data-mce-style=\"color: #555555; font-family: 'Lucida Grande', sans-serif; font-size: 14px;\">(4) Pour les personnes qui s\u2019int\u00e9ressent hautement \u00e0 l\u2019arch\u00e9ologie historique du Nord-Estam\u00e9ricain et qui veulent soutenir le Conseil en versant une cotisation plus \u00e9lev\u00e9e.<br><\/p><\/div><\/div><\/div><\/div><div valign=\"top\" class=\"wdform_footer wd-width-100\"><div class=\"wd-width-100\"><div class=\"wd-width-100 wd-table\" style=\"padding-top:10px;\"><div class=\"wd-table-group\"><div id=\"26page_nav1\" class=\"wd-table-row\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"wdform_preload\"><\/div><\/form><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Online Membership Form You can now purchase memberships using PayPal. After submitting the form you will be directed to PayPal to complete the application. Please include your email where you would like to receive the newsletter, since we are moving to an electronic only version! (See below) The October 2015 Newsletter (No. 92) will be [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-871","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Membership Registration Form - CNEHA<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cneha.org\/community\/membership-form\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Membership Registration Form - CNEHA\" \/>\n<meta property=\"og:description\" content=\"Online Membership Form You can now purchase memberships using PayPal. After submitting the form you will be directed to PayPal to complete the application. Please include your email where you would like to receive the newsletter, since we are moving to an electronic only version! 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