Association for Size Diversity and Health

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ASDAH Membership Application

 
Membership is open to anyone who supports the Mission, Vision, and Values of ASDAH (view) and whose work as a professional or advocate is in alignment with the Health At Every SizeⓇ Principles (view). Please review these statements prior to applying for membership to confirm your commitment to moving toward promoting wellness in a manner that does not judgte, place value on, or use weight as a proxy for health. 
 
To reflect the organization's commitment to being inclusive and eliminating barriers to participation, membership is not restricted by capacity to pay. The recommended membership fee is $75 for a twelve month period, with a minimum recommended fee of $3. Those able to contribute at a higher level are encouraged to do so, or you may enter any fee amount between those recommended. If the minimum suggested amount presents a barrier to joining, please send an email to membership@sizediversityandhealth.org so we can make individual arrangements. 

All membership applications are manually reviewed after submission, so there may be a short delay between confirmation of payment and activation of membership. Please do not hesitate to contact the ASADAH Membership Director at the aforementioned address if you have any concerns or questions about any aspect of membership. 

 

The information that you provide on this membership application will be used only in our internal membership records and will be password-protected. To maximize the security of your account we ask that along with selecting a password you answer one of three "secret questions" as noted below.

Required *
Prefix  
First Name*  
Middle Initial  
Last Name*  
Membership Fee*  
Please enter an amount between
$3.00 and $75.00 (recommended)
Check here if you are unable to pay
Are you a student?  
Yes No
Where are you currently enrolled?  
Degrees  
License/Certification  
Occupation  
Title/Organization  
Address (mailing)*  
Address (mailing - line 2)  
City *  
State/Province*  
(Add Option = NonUs.
Canada = drop down)
Zip/Postal Code*  
Country*  
Phone (primary)*  
(Please insert hyphens for all
phone #s, e.g. xxx-xxx-xxxx)
Phone (secondary)  
Fax  
Preferred Contact Method  
Email Phone
Preferred Email Format  
HTML Text
E-Mail (login ID)*  
Confirm E-Mail*  
Password*  
(password must contain at least one capital letter, one lowercase letter, one number and one special character and be at least 8 characters in length)
Confirm Password*  
Secret Question*  
Secret Answer*  
Join the ASDAH member email list?  
Yes No
Email for list (if different from Login ID)  
Website  
How did you hear about ASDAH?  
Other HAES Affiliations/Organizations
(e.g. NAAFA)		  
If you identify with one or more marginalized communities and feel comfortable sharing this information, please indicate your affiliations (e.g. POC)  
If you would like to make an additional donation to support the work of ASDAH (over and above your membership fee) please complete the following two items:
Donation Amount   $
Donation Fund  
Donations to ASDAH support our effective and much-needed educational and advocacy efforts and are tremendously appreciated.

Note: ASDAH is a non-profit organization classified as 501 (c) (6). Contributions, gifts, and dues to ASDAH are not tax deductible. ASDAH donations & dues may be deductible as business expenses -- please consult your tax professional.
Email in Member Directory  
Yes No
Phone in Member Directory  
Yes No
Yahoo! Group  
Yes No
Are you interested in volunteering?  
Yes No
ASDAH member materials (Member card, HAES Principles cards, brochures)  
Mail hard copied to me
Provide link to order or print online
Comments/Questions  
Security Image*    Refresh

     
CAUTION: Please make sure this form is complete and accurate before selecting your payment option. Once you have clicked on Pay Online or Pay by Mail attempting to click your browser BACK button will result in an application error.


The Association for Size Diversity and Health welcomes people of all sizes and shapes regardless of race, color, national origin, religion, creed, gender, age, marital status, sexual/affectional orientation, mental or physical disability, or veteran status.
Promoting The Health At Every Size® Approach
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P.O. Box 3093 Redwood City CA 94064   ~   877-576-1102 (toll free)   ~   www.SizeDiversityandHealth.org