Student Membership

Student Member Application Form

Membership Terms and Conditions
Student membership entitles the student member to participate in student associate affairs, with the exception of the right to vote. The student membership takes effect upon approval by the IHCA Board of Directors.
Payment Information
A student membership fee of $25.00 per calendar year must be sent to Iowa Health Care Association, 1775 90th Street, West Des Moines, IA 50266-1563 upon submission of application. By submitting an application, you understand that the student membership will be automatically renewed each year unless terminated, and you will be billed for the yearly membership fee.
Student Information
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
School Information
College, university or program attending * Required
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
School Advisor Name
Phone
Employer Information
The employer must be an Iowa Health Care Association (IHCA) member facility in order for student to qualify for IHCA Student Membership.
Are you employed by a long-term services and supports provider?
- Yes
- No
If yes, what is your job title?
Name of Long-Term Supports and Services Employer
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Supervisor Name
Phone
Student Applicant Name * Required
Date - must be mm/dd/yyyy format
Date Format: MM slash DD slash YYYY
Recommended by IHCA member (optional)

Student Membership

Student Member Application Form

Membership Terms and Conditions

Payment Information

Student Information

School Information

Employer Information