Affiliate Member Application

Instructions

Please note: Beginning January 2026, an active Affiliate Membership is required to participate as a sponsor or exhibitor at GHPCO's Annual Conference's.

2026 Conference sponsor/exhibitor fees will include GHPCO's 2026 Standard Affiliate membership dues.
Affiliate Membership for 2026 will now follow a calendar year cycle, running from January 1, 2026, through December 31, 2026. If you currently hold a 2025 Membership, it will remain active through March 31, 2026.

Membership dues from programs like yours is our largest source of funding, funding that allows the GHPCO to continue its vital work on your behalf in important areas such as advocacy, access and quality. Should you have any questions about the form, your membership, or if you would like to learn more about what you can do to partner with GHPCO, please let us know. We look forward to your participation in GHPCO throughout the year!

Select Your Option(s)

Affiliate Member $500 Annually + Price of Level Selected (Price Range: $0 - $500 Annually)

Select Level

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameBusiness Name

Please select a valid membership option and fee item if exist

Affiliate Member Application

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