Membership Application

Don't Be Left Out! Join your fellow NH Occupational Therapy professionals in promoting OT in our region. Membership in NHOTA makes a statement about your dedication to the profession, and encourages professionalism toward our specialty. Please utilize the field below to complete our membership application:

 

1. Personal
Date of Application:
Renewal or New Member
Name
Address 1:
Address 2:
City:
State:
Zip:
Home Phone:
Home Email:
   
2. Work Information
 
Employer:
Work Address 1:
Work Address 2:
City:
State:
Zip:
Work Phone:
Work Email:
   
3. Special Interest Sections
You are invited to join a special interest section. Members receive information on activities and educational events for your chosen areas, free of charge. Please click below to join the available SIS:
School/Pediatrics SIS
Physical Disabilities SIS
Mental Health SIS
 
4. Volunteering
NHOTA encourages its members to become actively involved in NHOTA activities and events. Volunteering can mean short-term projects or activities, or long-term elected or appointed positions. If you feel you can, please select from the following:

Executive Board
Newsletter
Legislative
Annual Conference
Public Relations
Continuing Education
Other, contact me.

   
5. Member Dues
OT-$50
OTA - $40
OT/OTA Student - $15
OT/OTA Retired - $25
If you would be interested in sponsoring another OT/OTA in joining NHOTA, please designate an amount and a particular OT/OTA (leave this field blank if you would like these donations to go into a general scholarship fund)
OT/OTA Name: Amount: $
   
6. Continuing Education Grant

NHOTA offers two continuing education grants for the shared benefit of the practitioner and the Membership. Grants will be awarded each year to two members of NHOTA, one Grant for an event occurring during the first half of the year and one for an event occurring during the second half of the year. Each grant will not exceed $300, the amount being determined by funds raised by the Scholarship Committee through donations. The benefits of these Continuing Education Grants will be shared with all NHOTA members via the Newsletter, website and/or other presentation. Your contribution to this Grant fund will benefit many in our association

$ NHOTA Continuing Education Grant

   
7. Specialty Certifications & Degrees
Please list your professional degrees, and any advanced certifications
   
8. Educational Needs/Speaker Bureau
One of our association's primary reasons for existence is to provide educational opportunities for membership. Please take a few minutes to let us know what your continuing educational interests are.
If you or someone you know is interested in speaking or presenting, please indicate this as well, below:
Please list the two most important methods NHOTA could assist you as a practitioner:
   
9. NHOTA Communications

One of the primary modes of communication from the association to its members is the NHOTA Forum. The forum provides our leadership the ability to inform members of upcoming events, necessary legislative alerts, special member benefits, as well as providing members the ability to share unique practice experiences. NHOTA subscribes each new member to our association forum as our official mode of communication. If you would like to unsubscribe, please sign into the Forum page and click Profile at the top. This will allow you to take yourself off of the forum lists. It is also important, once your ID# is assigned and you are put into the forum system, to visit the forum page and click on Digest at the top. This allows you to set up how you want to receive messages and how often. Messages on the forum are not sent out automatically to everyone, you need to be signed up in Digest to receive notices of new postings. Then you can access these postings via the Forum page.

WEBSITE/FORUM NOTE: The membership database is uploaded to the website twice per month. If you are joining after one of these uploads, you may experience a 2-3 week delay in obtaining nhota.org "member's only" access and access to the members only forum. If you need immediate access, please contact Diana Morin NHOTA Webmaster and Forum Moderator at web@nhota.org. Thanks for working with NHOTA.