of the American Industrial Hygiene Association
Ohio Valley Section Membership Application
Membership dues for the Ohio Valley Section of AIHA are currently being accepted for the 2007-2008 year. Please fill out the membership profile below and send $20 (free for full-time students) to the AIHA OVS Secretary:
Greg Fullenkamp
AIHA-OVS Secretary
Greg Fullenkamp, CSP
Wausau Paper / Bay West
700 Columbia Avenue
Middletown, Ohio 45042
937 470-0150
gfullenkamp@wausaupaper.com
Membership Profile:
Name:
Certifications/Credentials?
CIH
CSP
(other:
please list)
Title:
Company
Address
City State Zip
Office Phone
Office Fax
Email*
*Meeting announcements will be sent via email to individuals with email addresses on file
Committee Interest? YES NO
If yes, which one
(symposium/training, nominating)
National AIHA Member? YES NO
Interested in serving as an officer in the Local Section? YES NO
Membership Preferences:
1) Do you have any suggestions for speakers or meeting topics?
2) Meeting time you prefer: lunch evening both
3) Do you have any suggestions for meeting locations?
(PRINT CLEARLY PLEASE!)
Please print out, and send $20, or $0 for
full-time students,
to the OVS AIHA Secretary:
Greg Fullenkamp
AIHA-OVS Secretary
Greg Fullenkamp, CSP
Wausau Paper / Bay West
700 Columbia Avenue
Middletown, Ohio 45042
937 470-0150
gfullenkamp@wausaupaper.com
Thank you for your membership and your participation!