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Oklahoma Section of the American Industrial Hygiene Association
Application for Membership January 1, 2021 - December 31, 2021
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First Name
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Last Name
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Affiliation
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Street Address
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City
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State
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Zip Code
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Telephone Number
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Email Address
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Membership Selection
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Full Member $30 (Voting privileges, may hold position on OK AIHA Board)
Associate Member $18 (No voting privileges, may no hold board position)
Corporate Member $120 (No voting privileges of the corporation) 2 - Full, 10 - Associate
Retired Member Dues Waived (Voting privileges, may hold position on OK AIHA Board) (Must attach attestation that the member has retired from the industrial hygiene profession.)
If corporate membership selected, list two full members
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If corporate membership selected, list up to ten associate members
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Credentials (PhD, CIH, CSP, PE, CHMM, etc)
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Area of Expertise
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If elected, would you be willing to serve as an OK AIHA Board Member?
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