Join Us

Participate in joint efforts to achieve broader public health goals

Does your organization have a demonstrated commitment to promoting public health and advocacy? Can your organization offer expertise, resources, or networks that will enhance CAPHA's ability to influence public health policy and educate communities? Is your organization prepared to actively collaborate with other coalition members, share knowledge, and participate in joint efforts to achieve broader public health goals? Fill out the form below if your answer to the questions is YES, and you wish to join us.

Please complete the form below to apply for membership with CAPHA. Your submission will be reviewed, and we will contact you regarding the next steps.

Join Us

Organization Name

Organization Address

Contact Person:

Full Name

Position in Organization

Email Address

Phone Number

Other Information:

Mission and Objectives of Your Organization

Are you willing to engage actively in coalition activities and share resources with other members?

Yes

Are you willing to engage actively in coalition activities and shI certify that the information provided here is true and accurate to the best of my knowledge. are resources with other members?

Agree

Disagree

Additional Information

Participate in joint efforts to achieve broader public health goals

Please note: Completing this form does not guarantee membership. All applications are subject to review by the Coalition.