Women in Health Care Management

a Boston, Massachusetts based professional networking organization

Become a Member of Women in Health Care Management (or update your personal information)

You can submit an electronic registration form to WHCM. Please note that you will not be included in the database until your $50 annual dues check is received by WHCM. If you are already registered with WHCM and want to make changes in your information profile, simply enter your name and the new or changed information in the appropriate boxes. There is no need to re-enter unchanged information. Mail checks made payable to Women in Health Care Management to: WHCM, 84 Fenwick Rd. Newton, MA 02468.

  1. Please provide the following home contact information:
    First name
    This is an error
    Last name
    This is an error
    Middle initial
    Street address
    Address (cont.)
    City
    State/Province
    Zip/Postal code
    Country
    Home Phone
    E-mail
  2. Please provide the following business contact information:
    Title
    Organization
    Business address
    Address (cont.)
    City
    State/Province
    Zip/Postal code
    Country
    Work Phone
    FAX
    URL

  3. Preferred Mailing Address:

    home
    business

  4. Are you a new member, a renewing member, or are you updating personal information?

    new
    renewing
    demographic changes

  5. Professional degrees held:


  6. Prior affiliations/employers:


  7. To what other professional groups/associations do you belong?


  8. Are you interested in joining a small group?

    yes
    no
    already in one

  9. Are you interested in volunteering for a WHCM committee?

  10. Are you interested in being contacted by recruiters?

    yes
    no

  11. Select your employer or company type (if in transition, base on either target or former employer type):

  12. If your employer/company type is "other, specify:
    Company Type


  13. Select your major occupational function:

  14. If your primary function is "other, specify:
    Primary Function


  15. Select up to 5 areas of interest:

Submit your form below or print it out and mail it to the below address. If you are a new member please fill out the entire form.

Please note that your membership will become effective upon receipt of your membership dues. Mail your registration or your $50.00 check (payable to WHCM) to:

Women in Health Care Management
c/o M. Shane
11 Prescott Rd.
Acton, MA 01720