CCGH-CSIH

Registration for Membership to the Canadian Society for International Health

Please complete the form below.

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Membership option (Required) 

Today's date is: March 23, 2017

Type of membership

Regular$50.00$50.00
Student/Retired/Non-Wage Earner$25.00$25.00
Organizational$250.00$250.00
Regular$50.00$50.00
Student/Retired/Non-Wage Earner$25.00$25.00
Organizational$250.00$250.00
Honorary$50.00$50.00

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Profession: Please check the one that the most appropriately applies to you


















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What is your highest level of education







Areas of Expertise/Experience: (Check all that apply)












Your Involvement in CSIH: Are you interested in becoming actively involved in CSIH?








What is your language expertise (check all that apply)







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