IAHTI Community Individual Membership Application


Individual community memberships are $10 annually. To apply, please complete the form below. When you submit the form, you will be directed to our secure PayPal account to complete payment.

All fields marked with * are required.

Name*
First Last Suffix

Email*

Mailing Address*
Street Apt/Unit (optional)

City , State/Province/District

Zip/Postal Code Country

Phone*
Include country code if outside of U.S.

Questions or comments

I have reviewed this form and verify that all information provided is accurate.*