Greater Atlanta Health Information Management Association 2009 Membership Application January 1, 2009- December 31, 2009

Dear Health Information Management Professional,

If you are not currently a member of GAHIMA (Greater Atlanta Health Information Management Association), we would like to take this opportunity to invite you to join the largest local health information management association in the state of Georgia. With your annual membership renewal year will receive the following:

Free quarterly newsletters
Free admittance to all quarterly meetings, where you will earn 3-4 CE hours each meeting
Complimentary annual membership directory
Opportunity to network with your colleagues and other health care professionals
 

If interested in joining or renewing your current membership, please complete the form below (*required) and submit payment with a credit card or check.

1.  Select Your Membership Type:  Select One Active Corporate Student

2.  Demographic Information

*First Name:		*Last Name:
Credentials:		AHIMA ID:
Employer:		Job Title:
Email Address:		*Home Phone #:
Work Phone #:		Fax #:
*Mailing Address:
*City:                    *State:       *Zip

We encourage you to provide an email address in order to receive timely GAHIMA updates.  However, if you do not provide an email address, then GAHIMA correspondence will be mailed to you.

3.  Volunteer Interest

We need volunteers in our GAHIMA committees! If interested, please check the applicable box(s):

	Legislative		Program
	Membership		Special Events
	Newsletter		Technology
	Nominating

4. Acceptance of Terms and Conditions

I have reviewed and acknowledge acceptance of the terms and conditions which includes the insufficient check funds policy and the credit card terms and conditions.

*       Select Below Yes, I agree to the terms and conditions.

If you would like a copy of this completed membership form, please print a copy before you select "continue".

Please select "Continue" to complete the membership process.