All amounts are in US currency.
$244 USD - Professional (U.S.)
$100 USD - Industrial
$100 USD - Affiliate/Associate
$40 USD - Student
If you have a promo code, enter it below. Staff will check validity of promo code upon receiving your application:
Name on Card
Name (First, Middle, Last)
Date of Birth (mm/dd/yy)
Last Four Digits of SS/SI Number
the Business Owner
Number of offices:
Number of dispensers:
Do you train apprentices?
Address line 1
Address line 2
Email (for Directory and IHS Contact)
Preferred Mailing Address
Which title best describes you?
Hearing Aid Specialist
Is this a second career for you or have you switched careers or retired from a previous profession?
If so, what was your previous profession?
I am licensed/qualified to dispense hearing instruments in the following states/provinces/countries:
My license/registration number is:
I began dispensing hearing instruments in (year):
Credentials (i.e., CCC-A, AuD):
Some College or Trade School
Institution and Degree
If currently a student, program and anticipated licensing date
The IHS Advocacy Alliance funds legislative and regulatory efforts on behalf of the membership. To contribute, check the box that indicates your level of support. Your donation will be processed in US currency.
Other Amount - please specify below
Terms and Conditions
I agree that my membership payment will be processed in US currency (USD). I agree to abide by the Bylaws and Code of Ethics of the International Hearing Society and the Canadian Hearing Instrument Practitioners Society.
Do you agree with these terms?