NC ACDIS 2024-2025 Membership
Membership Renewal is now each April and May. 
Enrollment open April 1st - May 31st.

Two links should be addressed to complete the membership process.

1.  The form below to enroll for NC ACDIS records,
2.  Submit yearly fees of $30.00/yr via a secure Square Online Storefront.

Rounding out this application are some Chapter Business questions on how YOU can help NC ACDIS continue to provide continuing education while maintaining our growth.  We hope you will put some thoughtful consideration on how you can contribute to the NC ACDIS Chapter's continued success.

We thank you in advance and look forward to networking with you!

With gratitude,

NC ACDIS Leadership Team


Kay Blue- President 
Vinu Sen -President Elect
Barkha Batheja- Secretary 
Rosetta Obeng- Treasurer   
Joan Oliver - Social Media Coordinator
*Vacant*- Secretary Elect
*Vacant*- Treasurer elect 
*Vacant*- Social Media Coordinator Elect
​​
ncacdis@gmail.com


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Email *
First *
Last *
Credentials (CCDS, CDIP, CCS, RHIA, RHIT, etc)
Employer (Facility, Health System) *
Primary Contact Email address for NC ACDIS *
The address where you are able to access links from NC ACDIS
Secondary Contact Email Address for NC ACDIS
An additional account where you can receive our emails.
Phone Number
Address (Fill out if you need a pin)
include Street Number, Street; City, State, Zip Code
Please specify if you are are new member and if you would like a pin to be sent to you. Make sure your address is correct above. *
Captionless Image
My membership selection on the NC ACDIS Square Storefront will be *
Are you interested in becoming a board member *
Required
Are you willing to be a speaker for a NC ACDIS Chapter Meeting?
As a speaker, what topic(s) are you willing to present at  a NC ACDIS Webinar?
Are you willing to participate on an off-line committee whose work contributes to the success of our Conferences?  Is so, please indicate your areas of interest. *
Committee work is intended to be independent, self-paced work that can be done during the evenings or spare time (Emails, Phone Calls, Computer work, etc..) whose members report their progress to the Committee Leader
Required
If you are interested in the above Committee work, would you be willing to head the initiative and report your progress to the Board?
The Committee Leader will organize (emails, short individual phone calls, or rare short conference calls) the committee members’ independent effort towards a contracted goal with the Association Leadership Team Designee.   The Committee Leader will report to an officer who will then report (email, short phone call) the committee’s progress to Leadership
Clear selection
Any preferred location in NC for Winter conference 2024? *
Is your facility willing to host our Winter conference for 2024? 
If yes, please provide contact details. 
Are you a National ACDIS Member Member? *
Any comments you'd like to share with the NC ACDIS Leadership Team? (suggestions, questions, comments)
Would you want your email address shared with vendors should they ask? (They often ask us to share your emails during conferences and we have not shared any information. We will only share information with your permission.) *
A copy of your responses will be emailed to the address you provided.
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