Group Membership Application

Group Membership

When people from the same workplace join CSHA, membership dues are offered at a discounted rate.

Discount Options

6-10 Members (20% discount per member)

11+ Members (25% discount per member)

Please check which one applies:

Organization/Employer Name:

Contact Name *

Company Address *

Apt, suite, etc.

Country

City

State

Zip code

Contact Phone *

Contact Email *

Member #1 - Full Name *

Email *

Member #2 - Full Name

Member #3 - Full Name

Member #4 - Full Name

Member #5 - Full Name

Member #6 - Full Name

Member #7 - Full Name

Member #8 - Full Name

Member #9 - Full Name

Member #10 - Full Name

Member #11 - Full Name

Member #12 - Full Name

Member #13 - Full Name

Member #14 - Full Name

Member #15 - Full Name

Member #16 - Full Name

Member #17 - Full Name

Member #18 - Full Name

Member #19 - Full Name

Member #20 - Full Name

Printable Member Application (one per member)

https://cshassoc.org/member-center/membership-application.pdf

Upload Completed Member Applications for Each Member

Accepted formats: pdf, png, jpeg, gif

Credit Card Type *

Visa

MasterCard

Discover

American Express

Credit Card Number *

Expiration Date *

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