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SSA

Become an Organizational Member

Your organizational membership includes 2 professional members and 2 student members. Let us know who they are below. (*) indicates a required field.

Member 1 Information
*First name
*Last name
*Email
*Telephone e.g. 555-555-1212
*Street Address
*City
*State *Zip
Member 2 Information
First name
Last name
Email
Telephone e.g. 555-555-1212
Street Address
City
State Zip
Student 1 Information
First name
Last name
Email
Telephone e.g. 555-555-1212
Street Address
City
State Zip
Student 2 Information
First name
Last name
Email
Telephone e.g. 555-555-1212
Street Address
City
State Zip
Type of Organization
Hospital Home Care
Nursing Home OPD/Clinic
Senior Center Senior/Adult Day Care
Government University
Other:
Committees

Please check if you’re interested in learning about or participating in one or more of the following standing committees:

Awards Budget/Finance
Education Program
Student Committee Electronic Communications
Social Policy Membership
Nominations Publications
Planning & Development Committees & Standards
Areas of Interest
Community Services Disease Management
Long Term Care Nursing Homes
Retirement Wellness
Rehabilitation Therapy Mental Health
Education Income Security
Minority Public Policy
Senior Center Home Care
Traumatic Brain Injury
Continue membership application