ZBHA Membership Forms

Retired Membership

Retired Membership — $50/year

For certified ZB practitioners who are retired or no longer practicing
Stay connected to and involved in the ZB community while supporting our mission and programs.

Member Information

I am (please check one):
 Renewing my retired membership
 Rejoining after a lapse in membership
 Retiring from active certified membership
First Name:
Last Name:
Business Name:
Main Office Name:
Address 1:
Address 2:
City:
State or Province:
Zip Code:
Phone 1:         Home   Office   Mobile
Phone 2:         Home   Office   Mobile
Email Address:
Website Address:

Payment Information

Yearly Dues: $50

I would like to make an additional contribution to the Zero Balancing Health Association.
Amount of donation: $
I would like to make an additional contribution to support the work of Zero Balancing.
Amount of donation: $
Payment options (please check one):
 I'd like to pay online by credit card
 I'd like to pay by phone
 I will send a check: Payable to: ZBHA
Zero Balancing Health Association
8640 Guilford Rd., Suite 241
Columbia, MD 21046

Other Information

I receive the ZBHA e-newsletter.
I am interested in hosting a Zero Balancing class.
I would like to help an appropriate ZBHA committee.

 

Please include my name and email address on the Zero Balancing mailing list. We respect your privacy.
Please click the "Submit" button once. Thank you.

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