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Laboratory – Local Public Health Membership Application

Any of the public health laboratories of the counties, parishes, municipalities, cities, townships, boroughs or other localities within the United States are eligible to become Lab/PH Local Members.

Questions?

Contact the Membership team: [email protected]

Organization Information

Population Size Served:

Address

Contact Information

Member Representative Information

Member-Associate Information

Member-Associates are those laboratory staff chosen by the Laboratory Director to receive member benefits. Member-Associates may not vote but have the right to hold appointed (but not elected) office (e.g., committee chair, liaison, task force), to serve on committees and to speak from the floor of a general member meeting.

The amount of complimentary Member-Associate positions that your laboratory receives can be found in the Population Size Served section above. Additional positions can be purchased for $125 each.

Please provide contact information for the laboratory’s appointed Member-Associates using contact forms below. If you have more than five Member-Associates, please email the contact for the remaining people to [email protected].

 

Member-Associate #1

Member-Associate #2

Member-Associate #3

Member-Associate #4

Member-Associate #5

Payment

Membership is based on a July 1 to June 30 year. New members receive a 50% discount the first year.

View our current dues rates

Once your application has been received and reviewed by the Membership Team, you will be contacted with instructions on how to submit your payment.

Submission