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If you fulfill the eligibility criteria and interested in joining the Society or renewing your subscription, please complete the membership form, below. The annual subscription fee is $125 ($75 for retired alum).

Please fill out and submit the form and mail the annual subscription fee to:

PHLS
1515 Poydras Street, Suite 1200
New Orleans, LA 70112
anguyen@lphi.org

An invoice for the subscription fee will be sent if we do not receive a payment. A receipt is also available upon request. If you have any questions regarding membership, please contact PHLS

Member Application Form
Name & Degrees
Title
Organization
Address 1
Address 2
City
State Zip
Phone
Fax
Email
Leadership Program
Year Of Graduation
Check the item that most closely matches your professional affiliation State Other Federal Agency
Local International
Academic Health Systems
CDC Organization Liason
HRSA Other, Retired, Consultant