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Application for New Membership
Membership Application Instructions:
In making an application for membership in the Council on Nutrition, I agree to abide by its Constitution and By-laws, help advance its objective and increase its membership. I understand there is an application fee of $25 and annual dues of $150.
How to register:
Registering is a two-step process: First, complete this form about you. After successfully completing this form, you will be shown a link to provide online payment using a credit card on Square. Your registration is not complete until we've received your registration and payment.
About You
First Name
*
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*
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*
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*
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About Your Education
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*
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*
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*
Chiropractic College or University
*
Years
*
Date of Degree
*
More About You and Your Interests
Are you an ACA Member?
*
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No
Do you specialize in nutrition?
*
Yes
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Are you engaged in full-time chiropractic practice?
*
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Are you interested in a program that will inform the public on nutrition?
*
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Where should mailings be sent?
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Our mission is to encourage and promote a more advanced knowledge and use of nutrition in the practice of chiropractic for the maintenance of health and the prevention of disease.
I have read the above statements.
Thank you!
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