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GHSA Associate Membership Application

IMPORTANT INFORMATION: PLEASE READ BEFORE COMPLETING APPLICATION!
If you work for a State Highway Safety Office or existing GHSA Associate Member, you are already considered a member of GHSA.

GHSA Associate Members must agree to support the goals and objectives of GHSA and may not vote on Association policies. Associate Member dues support the general purposes of GHSA, including publications, training and research.

The GHSA Executive Board reviews all Associate Member applications quarterly. You will be notified after the next Board Meeting whether your application has been accepted. Associate Membership does not imply GHSA endorsement or grant permission to use the GHSA logo.

Select Associate Membership Category *

 
DUES PAYMENT
GHSA bylaws specify that Associate Member dues be assessed at the time of application. If paying by check, please mail your payment to:

GHSA Associate Member Dues
444 North Capitol Street, NW, Suite 722
Washington, D.C. 20001-1534

If paying by credit card, please call Margaret Maxwell at 202-789-0942 x100 to provide your credit card information.

If your application is rejected, your dues payment will be refunded.

Organizational Information

Primary Contact Information

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Web Listing

GHSA maintains a web page with the logos and descriptions of all our Associate Members.

 
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