Become a member

Registration form to become a member of APHVO

Please note that the annual subscription renewal takes place in June.

Name * Required
First Name * Required
Email * Required
Street address * Required
City * Required
Postal code * Required
State * Required
Home phone (enter the 10 digits without spaces or parentheses)
Cell phone (enter the 10 digits without spaces or parentheses)
I register as * Required
- Regular member - $ 5
- Associate member - $ 20
- Affinity member - $ 30
I would like to receive the documentation * Required
- In electronic version
- In large print
- In braille
- In audio
Total
$ 0.00 CAD