Premium (Upgrade from PACE)

APHA Premium Membership Application

Upgrade Application for Current APHA PACE Members

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Not quite ready to fill this out?
Learn more about APHA Premium Memberships.
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Things to Know:

1. Write down the ID and Password you choose.  You’ll need them when it’s time to log in.
2. Once you submit the form, you’ll be taken to a payment page which will reflect the full price of a Premium Membership ($289).HOWEVER!  Since you are upgrading from another APHA membership, that full price will not be correct. We need to do the math for you, and each individual applicant’s math is different. Your one year price will be discounted by the amount of time you have left on your current membership, and may be further discounted because you belong to another affiliated organization.SO!  When you hit the submission button at the end of the form, it will take you to a payment page.  Just click on SUBMIT – and it will take you to a confirmation page which will outline the next steps to be sure you get the pricing credits you deserve.
3. Sometimes submission takes up to a full minute. Be patient!  You do not need to click on SUBMIT more than one time.

Once payment is received, your application will be complete, and you’ll receive all the information you need to access your new membership.

*Required Fields

First Name:* First Name Required

Last Name:* Last Name Required

Address:* Address is Required

City:* City is Required

State or Province:* State or Province is Required

Zip or Postal Code:* Zip or Postal Code is Required

Country: Country is not valid

USA Canada Other

Country (Outside US and Canada): Country (Outside US and Canada) is not valid

Phone number:* Phone number is Required

Email (to match for renewal):* Email (to match for renewal) is Required

Current APHA Membership:* Current APHA Membership is Required

I am currently a PACE or PACE International Member I am currently a Premium member I am currently an Umbra Associate Member I am not an APHA Member

Do you hold any of these certifications?:* Do you hold any of these certifications? is Required

Board-Certified Patient Advocate (BCPA) Certified Senior Advisor (CSA) Certified Life Care Planner (CLCP) Certified Geriatric Care Manager (CGCM) Certified Medical Coder (CMC) Certified Case Manager (CCM) Social Worker (LCSW, MSW) Registered Nurse (RN) Certified Nurse Practitioner (CNP) Physicians Assistant (PA) Medical Doctor (MD) Pharmacist (PharmD) Occupational Therapist (OT) Physical Therapist (PT) Chiropractor (DC) Medical Assistant (CMA) Certified Nurse Assistant (CNA) Other None of the Above

Your experience (Please check all that apply):* Your experience (Please check all that apply) is Required

I have worked in a healthcare administrative role I have worked in a healthcare clinical role I have been an unpaid caregiver I have been a non-clinical paid caregiver I have had training in patient advocacy/care management/care coordination None of the above

I have read and agree to the APHA Membership Terms Of Service*

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Password Strength  Password must be "Medium" or stronger

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No val Please fix the errors above