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Annual Fee
Choose one of the following membership levels.
Fellow, FACW or Diplomate, DACW
$175.00
Certified Member
$150.00
Fellow /Diplomate and Certified Member
$200.00
Member
$130.00
Student Member
$45.00
International Member
$150.00
Associate Member
$250.00
Life Member
$1,000.00 (one time fee)
Certifications
One-Time Fee
Check any of the following certifications you wish to receive.
Certified Wellness Specialist CWS
$50.00
Certified Wellness Educator CWE
$50.00
Certified Wellness Consultant CWC
$50.00
Certified Wellness Healthstyle Coach CWHC
$50.00
Divisions
Annual Fee
Check any of the divisions that you want to join that might benefit your profession.
Social Wellness
$10.00
Physical Wellness
$10.00
Spiritual Wellness
$10.00
Emotional Wellness
$10.00
Vocational Wellness
$10.00
Nutritional Wellness
$10.00
Psychological Wellness
$10.00
Environmental Wellness
$10.00
__________________ (Other)
$10.00
Personal Information
Fill out the information below. Fields in
gray
are optional.
Prefix
_____
Email
________________
Full Name
_______________
Home Phone
________________
Address 1
_______________
Work Phone
________________
Address 2
_______________
Fax
________________
City
_______________
Occupation
________________
State/Zip
_____ ______
Degree
________________ (Highest earned)
Credit Card Information
Visa, MasterCard, American Express, and Discover cards are gladly accepted.
Number
______________________
Expires
____ / ______
Life Members: Payment Options
If you chose Lifetime Membership, choose how you wish to break up your payments.
Down Payment
$ ________ (Minimum $100.00)
Monthly Payment
$ _________ (Minimum $100.00)
TOTAL AMOUNT DUE
Total Due Today:
$______
Next Annual Fee:
$______