GEHA Member Update Form
This form is for current PAID members to update address, email etc. , for new membership or membership renewal, please return to Menu and select "Membership Application"
If you are unsure if you are a current paid Member, contact Georgia Environmental Health Association at:
GEORGIA ENVIRONMENTAL HEALTH ASSOCIATION
397 Eastman Hwy
Hawkinsville, GA 31036
or Email: geha@comsouth.net
* Required
Name * ......................First .................................................. Last
Home Address *
Street
. .City
State
Zip
Preferred Address
Daytime Contact Phone Number
Home Email Address *
Preferred Email
Company or Agency
Job Title
Business Address
Street
. .City
State
Zip
Preferred Address
Business Email Address
Preferred Email
Membership Type - Mark Type of Member - No Fee Assessed for Member Update *
Active Member
Associate Member
Honorary Member
Student Member
Membership Categories:
Active Members: those who are employed at or retired from jobs that involve environmental health as a major component of their occupation.
Associate Members: those who provide products for use in environmental health related activities or anyone with an
interest in environmental health.
Honorary membership: bestowed upon members by the Awards Committee.
Voting privileges in Association shall be limited to Active Members and Honorary Members only.