PRINTABLE APPLICATIONU.S.H.E. - MEMBERSHIP APPLICATION
Please print and complete this form - fill out all the requested information and mail with your check to:
U.S.H.E. – Utah Society for Healthcare Engineering P.O. Box 58301
Salt Lake City, Utah 84158-0301
If you have any questions please contact Libby Crapo at 801.856.9898.
Name:
___________________________________________________________________
Company:
___________________________________________________________________
Address:
___________________________________________________________________
Phone:
___________________________________________________________________
Fax:
___________________________________________________________________
E-mail:
___________________________________________________________________
Referred by:
___________________________________________________________________
Membership Type:
Annual Dues Member_____________________________________________$50.00 ea
(Individuals working at a Healthcare facility)
1st Associate Membership_________________________________________$225.00 ea
(Architects, Consulting Engineers, Contractors and Vendor/Suppliers)
This fee include one display table at the Spring Conference in St. George as well as free business listing on the USHE website.
Additional Associate Memberships_______________________$100.00 ea
College Students__________________________________________________$10.00 ea
College Faculty __________________________________________________$20.00 ea
Retired from the field of Healthcare Engineering_____________________$0.00
If you have any concerns regarding the website please send an e-mail to Rich Brunson @ richbruns@comcast.net Thank you for your support of our organization.