INSTITUTE OF HEALTH PROMOTION AND EDUCATION
![]() |
![]() |
![]() |
![]() |
![]() |
||
.. Skip navigation ..
Please print this page, complete this form and return to the Secretary: Professor A S Blinkhorn, University Dental Hospital, Higher Cambridge Street, Manchester M15 6FH, UK
I hereby apply for membership of the Institute of Health Promotion and Education as *Full/ Associate/ Corporate /Student Member (*delete as applicable), and agree to abide by the Constitution and Regulations and undertake to pay the Annual Subscription on the 1st January each year and in the event of my resignation I undertake to notify the Secretary in writing and return my Certificate by means of recorded delivery or registered post.
Surname
PROF/Dr/Mr/Mrs/Miss/Ms
Forenames
Address
Postcode
Honours, awards, decorations:
Degrees or Membership of Professional Institutions:
Name and address of professional reference (required for Member and Fellow grades)
I am at present engaged in Health Promotion/Health Education in a *full/ part-time capacity (*delete as applicable).
Present appointment
Organisation
Special Health Promotion/Education interests:
I enclose initial Registration Fee and Annual Membership Subscription: Total£
Signed
Date
Registration Fees |
Annual Membership Subscription | |
| Fellow | £10 | £50 |
| Members | £10 | £24 |
| Associate Members | £10 | £21 |
| Affiliate Members | £10 | £21 |
| Corporate Members | £10 | £30 |
| Student Members | £5 | £9 |
| Retired Members | - | £9 |
| Transfer between grades £10 | ||
For Official Use:
Date of Registration:
Membership No:
© Copyright Institute of Health Promotion and Education 1999-2007 Page last updated: 09.08.07