Student Membership Registration

Note: Student memberships are for individuals only

Prefer to Mail in your Registration to AHPCA?

Click Here to Register by Mail (printable form)

If you need further assistance with registration or have any questions please visit our Contact Page.

$15 Annual Student Membership*
- New Membership
Name*
First Last
Your Position
(Volunteer, Doctor, Nurse, etc)
Address*
Street Address Address Line 2 City Province Postal Code
Email
Enter Email Confirm Email
Phone*
I am currently attending the following educational institute:*
I understand that my student membership is incomplete until I provide proof of enrollment to AHPCA*
Yes, I agree
Proof of Enrollment (please provide ONE) sent to communications@ahpca.ca
- Scanned copy of your student ID card showing current enrollment
- Transcript or course list showing current enrollment
- Letter from your institution showing current enrollment
- Proof you have accepted an offer to attend an institution in the upcoming year
All documents must clearly show your name and the name and address of the issuing school.
Communication from AHPCA by email?*
- Yes
- No
Please confirm that you wish to receive communication from AHPCA.
Price*
- Annual Student Membership
$15.00 per year
April 1st – March 31st
Student members get 50% discounts on workshops
Add a Donation Amount?

If you would like to donate to the Alberta Hospice Palliative Care Association please enter an amount here.

Total will be updated on payment page.
Total
$ 0.00 CAD
How will you be paying?*
- Credit Card or PayPal Account
- Cheque
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