FHPW New Membership Application

Date

MonthDayYear

Membership Application

Quarterly Events
4th Monday of January, April, July, & October
The Ballroom at Tanglewood
5430 Westheimer Way, Houston, TX. 77056

Parking at no charge available on 3rd Level Parking Garage at
Intersection of Town & Country Blvd. / Plaza Way

For renewals of existing members, please go here: Membership Renewal

Member Organization*

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Current President*

President Direct Phone*

President E-mail*

Current Finance/Treasurer Officer*

Finance/Treasurer Officer Direct Phone*

Finance/Treasurer Officer E-mail*

Number of Member in your Organization

Organizations with 100 or fewer members can have up to two (2) delegates. Organizations with over 100 members can have up to three (3) delegates.

FHPW Delegate 1 (if selected)*

FHPW Delegate 1 Cell Phone*

FHPW Delegate 1 E-mail*

FHPW Delegate 2 (if selected)

FHPW Delegate 2 E-mail

example@example.com

FHPW Delegate 2 Cell Phone

FHPW Delegate 3 (if selected)

FHPW Delegate 3 E-mail

example@example.com

FHPW Delegate 3 Cell Phone

Website*

Month New Board Takes Office*

Number of Female Members*

Number of Male Members*

Please provide your Meeting Location, Date, and Time*

Social Media Links:

Facebook Page or Group

e.g. https://facebook.com/xxxxxxx

e.g. https://www.Linkedin.com/xxxxxxx

Instagram

e.g. https://Instagram.com/xxxxxx

Twitter

e.g. https://twitter.com/xxxxxxxx

Organization's Chapter or National Logo (300 dpi, high resolution)*

Upload File

.jpg Format Required

Required Documents:
The following documentation must be uploaded with your completed application. (Roster Information is optional).

Organization By-Laws (needs to include your mission statement)*

Upload File

PDF Format Required

Letter from your national organization approving your FHPW membership (if applicable)

Upload File

PDF Format Required

Copy of your organization's minutes approving membership into FHPW*

Upload File

PDF Format Required

Current membership roster

Upload File

PDF Format Required

Current President's Photo (300 dpi, high resolution)*

Upload File

.jpg Format Required

Membership Payment

Benefits of membership begin the date of your application and payment are received and processed. FHPW fiscal year is January 1st to December 31st with your first year membership dues prorated quarterly. For renewal purposes, membership starts on the first day of January. Dues payments are non-refundable and non-transferrable.

Membership Dues (joining Jan, Feb, or Mar)*

FHPW Membership Dues $125.00

Membership Dues (joining Apr, May, or Jun)*

FHPW Membership Dues $95.00

Membership Dues (joining Jul, Aug, or Sep)*

FHPW Membership Dues $65.00

Membership Dues (joining Oct, Nov, or Dec)*

FHPW Membership Dues $35.00

Payment Type

Credit CardCheck

Amount Due Calculation

PayPal

Pay by Credit Card*

USDFHPW Membership

Pay by Check

FHPW Membership