Membership Categories
Become a CCPH Member Today!
(Complete, or attach your business card here.
Applications for student membership must be accompanied
by a copy of a student identification card.)
Name
Title
Organization
Address
City
State
CountryZip
Phone
Fax
Email
e-Member Fee & Benefits
$90 Includes subscription to monthly Member
Highlights and biweekly Partnership Matters
e-newsletter, access to online membership
directory, discounts on publications, and
customized emails tailored to your self-identified
interests.
Individual Premium Member Fee & Benefits
$110 Includes all e-Member benefits, plus substantial
discounts on fees for CCPH sponsored
conferences, training institutes and other events.
$40
Website
Student Member Fee & Benefits
Includes all Individual Premium member benefits.
Proof of full-time student status required.
Organizational Member Fee & Benefits
How did you hear about CCPH?
Select a Membership Category
Individual E-Membership
$90
Student Membership
$40
Individual Premium Membership
*Organizational Membership
*Additional Person
$110
x $90 =
Total Enclosed:
$330
$
$330 Allows 4 people who are affiliated with an
organization to take full advantage of Individual
Premium member benefits. Organizational
members also receive one hour of free phone
consultation on a topic of their choice and
discounts on CCPH Consultancy Network
services. More than 4 people can be enrolled for
an additional discounted fee of $90 per person.
Select a Method of Payment
Check enclosed
Exp. Date
Name as it appears on the card
Signature
Billing Address
City Country
Phone
Zip
To join or renew online go to www.ccph.info & click on membership.
Checks: Please make check payable to CCPH and mail this form
with payment to:
CCPH • UW Box 354809 • Seattle, WA 98195-4809
The CCPH board invites you to join our growing network!
Membership is for one year from the date we receive your payment.
CCPH is a tax-exempt organization, Employer Identification
Number 94-3285533. All contributions to CCPH are tax-deductible
to the full extent allowable by law.
Ideas
—Alex Allen, Vice President, Community Planning & Research,
Isles, Inc., Trenton, NJ
I’ve attended a lot of professional education
meetings and without question, the CCPH ServiceLearning Institute was the most valuable both in
terms of what I personally and professional gained
from it. The benefits far exceeded the costs.
—Mary Ann Herlitzke, Physical Therapist Assistant Program,
Western Wisconsin Technical College, La Crosse, WI
Card Secuity ID#
State
Community-Campus
Partnerships for Health
CCPH has become an icon for service-learning
and community-based participatory research. The
networking opportunities and system of sharing
knowledge & information are priceless.
—Ruth Nemire, Associate Dean for Professional Education and
Community Engagement Professor Pharmacy and Health Outcomes,
Touro College of Pharmacy, New York, NY
Credit card payment (please complete below)
Type of card
What people are saying
about CCPH...
CCPH has helped me improve my relationship with
our partners. That is probably the most beneficial
part of my membership. I plan on being a lifetime
member of CCPH!
*Please list the contact person for the Organizational Membership
on this application & list contact information for the other 3 people
affiliated with the membership on a separate sheet. To include
more than four people on the membership, please add $90 per
additional person.
Credit card#
“
CCPH
UW Box 354809
Seattle, WA 98195-4809
Tel./Fax: 206-666-3406
ccphuw@u.washington.edu • www.ccph.info
“
Yes, I want to become a CCPH member!
Answers
Resources
Solutions
Building Healthier Communities,
Strengthening Higher Education
CCPH members are a diverse group of individuals
and organizations affiliated with colleges and
universities, community-based organizations,
health care delivery systems, student service
organizations, foundations and government. What
ties us together is our commitment to social justice
and our passion for the power of partnerships to
transform communities and academe.
CCPH is the most inclusive network of
people and information on communitycampus partnerships that I have ever found.
—Georgia L. Narsavage, Associate Dean for
Academic Affairs & Professor of Nursing,
Medical College of Georgia, Augusta, GA
Community-engaged scholarship
Partnership assessment & improvement
Grant writing & fundraising
I was actively seeking a membership
organization that supports community
development when I discovered
CCPH. It is the only one I have found
that provides global opportunities for
networking and sharing of best practices!
—Jennifer Churchill, Director,
Community Development, York Region Health
Services, Newmarket, Ontario
Venues to network with over 500 participants
with diverse knowledge and experience
Opportunities to share your skills & lessons
learned
Receive useful publications and resource
materials - for free or at a discount
Access low cost, high quality training and
technical assistance
The CCPH conference is our premier event for networking
and professional development.
Our Information Clearinghouse keeps
you informed. Tap into a wealth of
resources through CCPH!
CCPH Website — a treasure trove of resources
to support community-campus partnerships.
Web pages devoted to Funding Opportunities;
Awards & Fellowships; and Calls for Papers &
Presentations are updated regularly
Partnership Matters Newsletter — this
selective compilation of time-sensitive news is
emailed to members every other week
Electronic Discussion Groups — interactive
listservs that provide helpful resources and
answers to frequently asked questions
My position in health professions
education leads me to belong to
several professional organizations. My
membership in CCPH is by far the most
rewarding, professionally and personally.
—Chuck Conner, Site Coordinator, West Virginia
Rural Health Education Partnerships, Spencer, WV
CCPH regularly sponsors training institutes.
Our training with a CCPH consultant
was so impressive that we invited her
back.
—Vickie Ybarra, Director,
Planning & Development,
Yakima Valley Farm Workers Clinic, Yakima, WA
Training institutes in service-learning,
community-based participatory research
and community-engaged scholarship are
regularly sponsored by CCPH. These feature:
Pursue professional development at discounted
rates
Connect with colleagues who share your
passion for partnerships and social justice
Dynamic keynotes, skill-building workshops,
informative posters & exhibits, inspiring
community site visits, and opportunities to
speak with funding agency representatives
And much more!
Be the first to hear about funding opportunities
and other important news
Influence policies that affect communitycampus partnerships
CCPH conferences emphasize inclusion,
experiential learning and subsequent
action. Outcomes have included principles
of good practice, policy recommendations,
and new approaches to partnerships. CCPH
conferences feature:
Resources
Community-based participatory research
Conferences
Service-learning courses & programs
Training Institutes
Founded in 1996, CCPH is a growing network of
over 1,000 communities and campuses from across
North America and increasingly the world who
are working to improve the health of communities
through service-learning, community-based
participatory research, broad-based coalitions and
other community-academic partnership strategies.
These partnerships are powerful tools for improving
health professional education, civic engagement
and the overall health of communities.
The CCPH Consultancy Network provides
customized training and technical
assistance to community organizations,
colleges and universities, professional associations
and grantee networks. CCPH consultants are “real
life” practitioners who have experience in the full
scope of community-campus partnerships and can
lead workshops and give presentations on:
Consultancy Network
Overview
Why Join CCPH
Community-Campus Partnerships for
Health is a nonprofit organization that
promotes health (broadly defined) through
partnerships between communities and higher
educational institutions.
Experiential and didactic approaches to teaching
and learning
A unique mentoring model in which participants
work in small groups and as individuals with
leaders in the field to shape their own learning
and action plans
Publications – resource guides, fact sheets and
reports that highlight the latest trends, promising
practices and practical solutions
Monthly Member Highlights — helps you
stay connected to CCPH events, activities and
opportunities for involvement
CCPH Staff — staff are knowledgeable, helpful
and responsive to your requests