Membership Application | ID Acupuncture Assoc

First name

Last name

Email (associated with your NCCAOM account)

Phone

Address of clinic

Acupuncture license number

You are paying for IAA membership, which includes the conference. Will you attend the conference?

Yes

No

Maybe, please reach out to me

If attending, please select how you will attend:

Online- with GoogleTeams

In person

Combination of both in person and online

will you attend the IAA Conference dinner and Annual Membership Meeting?

Yes

No

If attending the dinner, how many will attend? (bring your loved ones!) Dinner $45/person

If attending dinner only and not the conference, please indicate your commitment here and any guests you want to bring:

What can you offer the IAA? Please and thank you! (Check all that apply)

Write an Article for the Newsletter

Attend Monthly Online Meetings

Conference Planning and/or Conference support

Donations

Help us grow membership through community outreach

Host Local Community Acupuncture Event

Interested in an Officer Position

Not Interested in helping

Other ways you are willing to help/volunteer for the IAA:

I agree to receive communications from the Idaho Acupuncture Association:

Yes

Membership Registration