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Bullet 3 About OAHE 
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Bullet 9 Contact Us 
Bullet 10 Links 
Bullet 11 Join OAHE 
Annual Membership/Renewal Application
(Please fill in All the Blanks)

To join OAHE print out this page with minimum page margins and fill out all the blanks or you can download the application in Microsoft Word format.

Check any of the following that apply.

  New Member                                   Renewal
  Individual Vendor Membership           Individual Engineer Membership

Applicant/Contact Name                                              Position/Title


Home Address                                          City                             State              Zip


Home Phone/Area Code                            Business Phone(DID)/Area Code


Hospital/Company Name                           Fax Number/Area Code


Hospital/Company Address                        City                            State               Zip


Email Address


Applying for membership as:         Engineer ($75.00)                No Affiliation Vendor Member ($125.00)         Platinum Affiliation Vendor ($1,600)      Gold Affiliation Vendor ($1,200)       Silver Affiliation Vendor ($700)


Applicant Signature                                    Member of ASHE          Date
                                                                         Y      N


Membership fee in the amount specified above, depending on membership type selected, must accompany this application.  Make checks payable to:  OHERFT (405-427-9537)

Method of Payment:

 

            Check in the amount of $____________ payable to OHERFT is enclosed.

          Please see new mailing instructions below.

 

            Credit Card #________________________________________________

                                                Visa – Mastercard – Amex

            Expiration Date _________Name on Card_________________________

            Credit Card Billing Address (Including zip code) ________________________

__________________________________________________________

            Signature___________________________________________________

 

Mail all registrations accompanied by a check to:

OHERFT, Dept. #96-0298, Oklahoma City, OK  73196-0298 (405-427-9537)

 

Mail all other registrations to:

OHERFT, 4000 Lincoln Blvd., Oklahoma City, OK  73105


Note: Application must be filled out annually when you pay your dues.


Contact us if you have anymore questions.