APPLY FOR NAHTM MEMBERSHIP ONLINE

Fill out the online registration form and we will review your application and forward additional information.


First Name:
Last Name:
Organization:
Title:

Email:
Phone:
Fax:

Address 1:
Address 2:
City:
State:
Zip Code:

Organizational Structure:
# of full time employees:
# of beds:
Do you use automated dispatch software?
If yes, please provide system vendor (or developed in house):
List functions performed by your department: