Join CFPHD

CFPHD annual dues support the activities of the CFPHD only (meetings, mailing, copying). We are grateful to the organizations and individuals committed to reducing health disparities in Central Florida for their donation of time and effort.

YES, I want to become a member of CFPHD.

Membership Type	Check one	Annual Dues (per individual)
Informed Member
Participating Member		$ 25.00

Membership Information (Required):

Prefix:

First Name:

Last Name:

Initial(s):

Organization:

Position:

Physical Address:

City, State, Zip Code:

Phone Number (daytime):

E-Mail Address:

Web Site:

Annual membership dues are $25.00. Checks should be made payable to the Central Florida Partnership on Health Disparities, marked "Membership," and mailed to:

Central Florida Partnership on Health Disparities (CFPHD)
P.O. Box 621554
Oviedo, FL 32762