CLHE Renewal Form

IMPORTANT: When using the online form, if you have any problems with your credit card going through, please call CLHE at (561) 792-4440. Many times the error could be a wrong credit card number, or for institutions, the business office may be blocking charges.

Institutional/Organizational Members/Schools of Education Members: Please fill out a form for each individual you would like to receive CLHE benefits as part of your membership.

Membership Category

Name and Address Information

*First Name:
*Last Name:
*Primary Representative	(*Required for Institutional/ Organizational Members only)
*Secondary Representative	(*Required for Institutional/ Organizational Members only)
*Title
*Institution
*Address 1:
Address 2:
*City:
*State:
*Zip Code:
*Country:
*Email:
*Phone:	--