How To Join and Pay Online

Please Note: Though we respect your choice of browsers our Payment Processing solution requires the use of Microsoft Explorer. Support for other browsers will be forthcoming. All fields are required unless marked optional.

Date
First Name
Last Name
Title
Company
Address
City
State
Zip
Phone
Fax (optional field)
Email
Years of service in healthcare:
Please indicate if you are renewing an existing membership or registering as a new member:
Renew	New Membership
Membership Category Annual Dues Primary Member $125.00 Corporate Member (up to 4 per organization)* $300.00 Student Member $75.00
*$75.00 per person additional corporate members Which two best describe your responsibilities: Planning Physician Relations/Recruiting Sales Physician Practice Management Marketing Network Development Financial Planning Managed Care Contracting Other (Specify)   Program Interests a. Managed Care Issues e. ElderCare b. Strategic Planning f. Network Integration c. Physician Network Development g. Complementary Medicine d. Senior Living h. Surviving as a Community Hospital   i. Other We have some volunteer roles available to maximize your investment in NESHS. Please check one or more of which you would be interested in participating: (optional) Program Committee   Membership Committee