Membership Application

Health Enhancement Research Organization Inc. (HERO) is a 501(c)(3) Non-Profit Corporation, EIN 63-1141480

This application is for organization membership.

Membership Contacts

Please provide contact information.

Primary Membership Contact

Name(Required)
Address

Secondary Membership Contact

This is optional. You can add a secondary member of your organization as a contact if you choose.
Name
Address

Membership Type

Membership renews on an annual basis. Dues may be paid annually or in two semi-annual installments upon request. Please select from the options below. Membership dues are based on your organization's category.
Membership Type(Required)
*corporate employers only, certain restrictions apply
This field is hidden when viewing the form
Membership Type (old)(Required)
*corporate employers only, certain restrictions apply

Billing Contact Information

Please enter the organization's billing contact information for invoice purposes.
Name(Required)
Business Address(Required)

For any questions or more information, contact Pat Rohner at pat.rohner@hero-health.org

©2024 Health Enhancement Research Organization ‘HERO’

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