Join NEHA Today in Two Easy Steps...

• Step One: Complete the Membership Form below;
• Step Two: Once you submit the membership form, click on return to form and go to the bottom of this page to submit your membership payment with PayPal.
• PLEASE NOTE:  if you are renewing your membership with this form, you only need to put your name and any changes you are making, you do not need to fill in all of the information.
   However PLEASE FILL OUT THIS FORM even if you only click the box that says renewal and paypal or check.  Thanks so much.  NEHA Membership committee
  If you prefer, you may simply Download the Membership Application Form
  by clicking the link, print it, fill it in, and send with your check payment to:
  Northeast Herbal Association
  PO Box  1629
  Kingston, RI   02852

Step 1: Fill out this
Membership Application Form:

First Name
Last Name
Business Name
Address 1
Address 2
City
State
Zip
Phone number
Fax
Cell number
Email
Website
Dues	Basic Membership Business membership Student membership
Amount enclosed
Do you wish you to recieve a scholarship?	NO YES   if yes, briefly explain why
Provide a brief description of what you wish others to know about you for your directory listing in 20 words or less
Check appropriate	wildcrafter    practitioner     products      crafts student        retailer    educator    grower wholesaler
New member or renewal	New Member Renewal
If renewal are there any changes?	Yes No
Paying via paypal or check	Paypal Check

Step two: Submit your membership payment with paypal (please click on the appropriate button for the amount that you are paying)
Basic Membership		Business Membership		Student Membership
$  45.00		$   65.00		$ 15.00
$  60.00		$   75.00		$ 25.00
$  75.00		$ 100.00		$ 35.00
$ 100.00		$ 125.00		$ 50.00
		$ 150.00
I would like to make a donation to the Lyn Li Reisin Memorial Fund for Children (click here to see information)			I Would like to make a donation the the NEHA Environmental Grant  (click here to see information)
$  15.00			$  15.00
$   25.00			$   25.00
$   50.00			$   50.00
$   75.00			$   75.00
$ 100.00			$ 100.00