Fill out the form below on your computer, then print and send along with your check, made out to NHLA, to: Kathryn Sicard, NHLA Business Manager, PO Box 68, Derry, NH 03038.

Click the printer icon to print the form after you have finished filling it out prior to submitting your application.

 

Members
Only lower case letters (a-z) and numbers (0-9) are allowed.
Physical Address
Physical Address
City
State/Province
Zip/Postal
Do you have a different Mailing Address?
Mailing Address
Mailing Address
City
State/Province
Zip/Postal
Would you be willing to serve on an NHLA committee?
Committees I am willing to serve on
Annual Dues
NHLA Scholarship
Billing Preference
Industry Type
Enter as a consecutive line separated by commas between services

Fill out the form above on your computer, then print and send along with your check, made out to NHLA, to:

Kathryn Sicard, NHLA Business Manager
PO Box 68
Derry, NH 03038