Membership

A one-year individual membership in the Disability History Association is thirty ($30 U.S.) dollars per year. Students may join the organization for fifteen ($15 U.S.) dollars per year. The DHA offers institutional memberships at the rate of one hundred ($100 U.S.) dollars per year. Membership dues help to support the organization's activities and goal of promoting the study of the history of disability.

To join the Disability History Association, please fill out the form below. Dues may be paid through PayPal.com, or you may send a check or money order (made payable to the Disability History Association) to the address below. To pay by credit card, complete the form below, and then go to http://www.paypal.com. Follow the directions indicated, and use disability.history@gmail.com as the recipient email and the amount indicated below. If you would prefer, we also offer a printable form that can be mailed to our Treasurer, Sandy Sufian.

Sandy Sufian, PhD, MPH
Department of Medical Education
808 South Wood St, 9th Floor
College of Medicine East, MC 591
UIC School of Medicine
Chicago, IL 60612

We respect your privacy and will keep the information you provide confidential. We will use it internally to enhance services to members. In addition, we need some of this data for reporting to maintain our nonprofit status. Providing demographic data is optional.

Membership Status: New Member
Renewing Member
First Name:
Last Name:
Institution/Organization/Company:
Address:
State:
Zip Code:
Country:
Email Address:
Historical Field of Interest:
Occupation: (For example:Advocate; Museum/Library; Student (undergraduate); Student (graduate); Teacher (junior high/middle school); Teacher (high school); Teacher (college/university); Other.
Date of Birth:
Disability:
Ethnicity/Race:
Gender:
Category of Membership:

For questions about membership and dues, please contact Sandy Sufian, DHA Treasurer, at sufians@uic.edu, or Audra Jennings, DHA Secretary, at jennings.160@osu.edu.