NY Metro ASHI

The Founding Chapter

                                                                         

 

 

Please print this page for your records and include a copy when sending your check to:

NY Metro ASHI Membership
25 Dahlia Drive
Mahopac, NY  10541

Dear First_Name,

You have successfully joined or renewed your membership with NY Metro ASHI!!

The following is the information you entered:

First_Name  MI  Last_Name
Title, Company
Street
City, State  Zip
Work Phone: Work_Phone
Cell Phone: Cell_Phone
FAX: FAX
E-mail: Email
Website: Website
Membership Type: ASHI_STAT
Member/Candidate #: ASHI_NUMBER
State License Number
NY-NY_LIC_NUM            CT-CT_LIC_NUM
NJ-NJ_LIC_NUM             MA-MA_LIC_NUM

If any of this information is incorrect, please go back to the registration form and change it. 


You may return to the registration form by using the Back button in your browser.
Revised: August 11, 2012 .

UPCOMING EVENTS

                               

Send mail to webmaster@nyashi.com with questions or comments about this web site.
Copyright 2004 NY Metro Chapter
Last modified: January 30, 2015