Massachusetts Health Council

Welcome 
 to MHC
About Us
Officers & 
 Directors
News & Events
MHC 
 Reports
MHC 
 Members
Membership 
 Benefits
Membership 
 Application
Contact 
 Us
Make A 
 Donation
Looking for 
 MassHealth?
MA Health Care 
 Reform Info

 

My Health Care Options

Membership Application

To become a member of the Massachusetts Health Council ...

  1. Complete the form below.
  2. Print the page.
  3. Attach your check made payable to "MA Health Council"
  4. Mail your application and payment to:

Massachusetts Health Council, Inc.
73 Oak Street - 1st Floor
Newton, MA 02464-1438

Amount due is on a sliding scale.
Please submit the appropriate amount for your organization.

Dues Schedule

Annual Revenue

Dues Amount

Under $100,000

$100

$100,000 - $300,000

$300

$300,000 - $750,000

$600

$750,000 - $1.5 Million

$750

Over $1.5 Million

$1,000

Name of Organization

 

Address of Organization

 

City, State, Zip

 

Telephone Number

 

Fax Number

 

E-mail Address
(very important for timely updates)

 

Web Address

 

Executive Director

 

President/CEO

 

Other contact person
(please add title)

 

 
 

The Massachusetts Health Council is an organization of organizations. This category is only available to people who have retired from a qualified organization or do not work for a qualified organization; e.g., an independent social worker.

If your organization is a member and you would like a separate individual membership or if you are not affiliated with a qualified health care organization, are retired or work as a consultant and wish to join, please fill out the membership application below.

Individual membership dues are $50.00

Name

 

Title

 

Address

 

Telephone Number

 

E-mail address for timely updates

 

 
 

Name of Applicant

 

Date

 

 

PAY DUES ONLINE

INDIVIDUAL MEMBERSHIP

Dues Amount

 

$50

 

ORGANIZATION MEMBERSHIP

Annual Revenue

Dues Amount

 

Under $100,000

$100

 

$100,000 - $300,000

$300

 

$300,000 - $750,000

$600

 

$750,000 - $1.5 Million

$750

 

Over $1.5 Million

$1,000

 


© Copyright 2003-2010 Massachusetts Health Council, Inc. All rights reserved.
MA Health Council, Inc. • 73 Oak Street - 1st Floor • Newton, MA 02464 • (617) 965-3711
Massachusetts Health Council is a non-profit, tax exempt organization.

This site is best viewed at 800x600 screen resolution.

MouseWorks Web Site Design & Hosting