LTCNA Membership Application IHCA Application Select An Option Associate Member $1875 Annually Individual Member $225 Annually Student Member $50 Annually The Center Family/Guardian Member $50 Annually Facility Member – CILA (The Center) Facility Member – ID/DD (The Center) Facility Member – MC/DD (The Center) Member Corporate Office Facility Member – AL (IHCA/ICAL) Facility Member – Sheltered Care (IHCA/ICAL) Facility Member – SLP (IHCA/ICAL) Facility Member – SNF (IHCA/ICAL) Enter Contact Information Prefix (i.e. Mr. Mrs. Dr.) First Name Last Name Suffix (i.e Jr. Sr. III) Designations RN RSC MSN BSN E-mail Family NameBusiness Name View Membership Terms Next Please select a valid membership option and fee item if exist Powered By GrowthZone
