Asian Pacific Islander Caucus Membership Form
Membership is open to anyone interested in addressing public health issues affecting Asians, Native Hawaiians and Pacific Islanders in the United States and associated jurisdictions in affiliation with the American Public Health Association. Membership is free and includes lifetime benefits to APIC sponsored events and access to APIC networks and listserv. However, we depend on and appreciate your annual voluntary contributions which allow us to continue to advance API health priorities through the APHA.
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First Name *
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Last Name *
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Degree(s)
E.g. MD, MPH, MS, etc
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Title
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Organization *
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Street Address
E.g. 123 Main St.
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City
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State *
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Zip Code *
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Phone
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Fax
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Email *
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Are you an APHA Member? *
Which APHA Section, SPIG, Caucus or Forum are you a part of?
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How did you hear about APIC?
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Are you interested in volunteering for the Caucus?
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Outreach/Membership
Policy/Advocacy
Abstract Review
Website
Event Planning
Student Mentor
Awards Committee
Would you like to be added to the listserv? *
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