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Membership Application
Apply for NHA membership by filling out the form below. Or download our printer-friendly form.

1. Membership Type: Choose One
Sustaining: $19,100

Industry: dues are based on annual revenue. Dues chart will appear in the Payment section below.

Industry Associate: dues are based on annual revenue. Dues chart will appear in the Payment section below.

Small Business: $2,600
Government/Non-Profit: $2,600
University/Education: $1,300

2. Your Organization
* indicates a required field
*Name
*Web site
www.company.com
*Profile
Check any keywords below that are applicable to your organization
Auto Company Compression Systems Electrolyzer Energy Company
Fuel Cells Hydrogen Fueling Station Industrial Gas Company Internal
Combustion Engines
National
Laboratory
Nuclear Production Reformation
Renewables Storage Systems Packaging Transit/
fleet operator
  University Utility  
       
3. Your Representatives
* indicates a required field
Primary Representative
*First Name *Last Name
Title
*Address 1
Address 2
*City *State/Province
*Postal Code *Country
*Phone *Email
       
Alternate Representative    
First Name Last Name
Title
Address 1
Address 2
City State/Province
Postal Code Country
Phone Email
       
4. Payment
* indicates a required field
*Payment Type      
Credit Card Check Invoice/PO Wire Transfer
       
       

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