OCAIHA Membership Form

Annual Membership Dues:
June-Dec: $ 25.00
Annual Membership: $50.00
Student Membership: $25.00 (Full-Time Students, Anyone Unemployed)
Retired: No Charge
Membership Cycle will change to Jan-Dec starting in 2009 for all
Date: 3/14/2010

Name_______________________________________________ CIH?: ____Yes ____No

Company_______________________________________________________________

Mailing Address*_________________________________________________________

City___________________________ State_________________ Zip code ________

Telephone*_______________________________ Fax_____________________

Email__________________________________________________________________

* Address and Telephone Number will appear in the membership directory

Amount Enclosed        ____$50.00        ___$25.00       ___Retired
Address Change         ____ Yes           ___ No
Are you a member of National AIHA? ____ Yes           ___ No

Make Checks Payable to OCAIHA and return form with check to:
OCAIHA
P.O. Box 4704
Irvine, CA 92616-4704

Section member benefits:
Support legislative advocacy of the IH profession through the California Industrial Hygiene Council
Reduced Orange County Section meeting charge
Local Section newsletter “The Orange PEeL”
Networking through meeting announcements & social activities
Reduced symposium registration fees
Employment search support
OCAIHA Tax Payer Federal I.D. # 31-1272346