NC SOPHE Membership Form
Thank you for joining/ renewing with NC SOPHE.
Name
Your answer
Degree/ Certification
Your answer
Email
Your answer
Alternate Email - Students, please provide an alternate email.
Your answer
Preferred Mailing Address
Your answer
Home/ Cell Phone
Your answer
Are you a member of National SOPHE?
If so, what is your National SOPHE join date?
Your answer
Is this a membership renewal?
Type of Membership
Race/Ethnicity
Demographics used for National SOPHE Reporting. Not required.
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