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HVDA Online Application
Not a Member?
After you have completed this online application, please send a check for $30 ($10 for students) payable to Hudson Valley Dietetic Association to:
Christine Marotta
21 Cypress Drive
Glenville, NY 12302
Once your application has been processed you will receive an email for web access and you name will be included in the Online Member Directory.
Member (without an online member profile)?
If you are an active member, once your online application has been processed you will receive an email for web access and your name will be included in the Online Member Directory.
Member (with an online member profile)?
Log into the Member's Only section of the website and click Renew Membership.
ADA Registration Number
*
:
ADA Membership Category :
Active
Associate
Retired
Student
First Name
*
:
Last Name
*
:
Credentials (RD,CDE,CDN,MBA,MS,etc.) :
Please note that "RDE" & "RD eligible"
are not ADA approved credentials
Email Address
*
:
Password
*
:
Retype Password
*
:
Age :
Under 35
Over 35
Home:
Address 1
*
:
Address 2 :
City
*
:
County
*
:
State
*
:
Zip/Postal Code
*
:
Work:
Address 1
:
Address 2 :
City
:
State
:
Zip/Postal Code
:
Phone (Day) :
Phone (Evening)
*
:
Phone (Mobile) :
Areas of Intrest
:
Committee Participation
Website Maintenance
Membership Mailing
Fundraising
The need occasionally arises for
the services of a foreign speaking dietitian.
Do you speak another language?
No
Yes
If so, which language(s) do you speak?
* Required
Questions or comments? Contact the Hudson Valley Dietetic Association at
info@hvda.net
Gonyea Computer Works
© copyright 2006 Hudson Valley Dietetic Association, Inc