CCIH Membership Application - Organization
The mission of Christian Connections for International Health (CCIH) is to promote global health and wholeness from a Christian perspective. CCIH shares information and provides a forum for dialogue, networking, and advocacy to the spectrum of Christian organizations and individuals working in global health.

Please select membership or affiliate category for which you are applying.

The CCIH Board of Directors will review your application and inform you of its decision. Annual dues are assessed on a sliding scale, according to an organization's annual budget. Please refer to the CCIH website under Membership > About Membership and Dues (www.ccih.org/about-membership-and-dues.html) for a complete listing of dues levels.

Membership Type
First Name
List first name of the organization's primary point of contact.
Your answer
Last Name (Family Name)
List last/family name of the organization's primary point of contact.
Your answer
Title (Position)
List job title or position of the organization's primary point of contact.
Your answer
Organization
Your answer
Organization Website Address
Your answer
Email Address
Your answer
Phone Number
Your answer
Street Address
Your answer
City, State, Zip Code
Your answer
Country
Your answer
How did you hear about CCIH?
Your answer
Can you tell us a little bit about your interest in joining CCIH? What inspired you?
Your answer
On which issues does your organization work?
Check all that apply.
Required
Describe your organization's work if not covered in the questions above.
Your answer
How many community-based prevention and care projects does your organization operate?
Put zero if none.
Your answer
How many hospitals does your organization operate?
Put zero if none.
Your answer
How many clinics does your organization operate?
Put zero if none.
Your answer
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