Registration Type(Required)New MembershipMembership RenewalComplimentary Membership (reserved for those who have been in healthcare facilities mgmt. less than 5 years and have never been a PSHFE member)Membership Type(Required)– Select –Associate MembershipVoting MembershipVoting Membership (Complimentary)Voting members must work for a healthcare providing facility that operates in Pennsylvania.Name(Required) First Last Title(Required)Organization Name(Required)Email(Required) Phone(Required)Secondary Contact Email Address Option Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you currently a member of ASHE (American Society for Health Care Engineering)?(Required) Yes No Pay By Check I will mail a check/money order to P.O. Box 212, Middletown, PA 17057 (be sure to include your name on the payment) I am eligible and applying for a complimentary voting membership Total Credit Card(Required)Card Details Cardholder Name Δ
