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: $______