Membership Information

Name (Please Include Credentials): 

Home Address: 

City:     State:

Zip: 

Work Phone:

Home Phone: 

Email Address:

Current Position: 

Special Interests:

I am interested in serving on the following committee's:

  Membership
  Professional Educational/Program 
  Public Relations 
  Nominating Committee 
  By-Laws 

Please check the type of membership that you are applying for:

Active $25
A health care professional providing education for patients and/or health care providers in or through hospitals, clinics, or private practices.
*Benefits 1, 2, 3, 4, 5, and 6

Associate $ 15
A person interested in diabetes patient education.
*Benefits 1, 2, and 3

Corporate $30
An employee of a company whose business manufactures, sales, markets, or promotes a specific diabetes care product.
*Benefits 1, 2, and 3

Student $5
A person enrolled in an undergraduate or graduate degree health professional program.
*Benefits 1, 2, and 3

* Please note the membership benefits:

1. Receive PARADE newsletters/mailings/membership packet.
2. Receive member discounts for meetings and activities.
3. May serve on the PARADE committees.
4. Must be a member of AADE. (New as of 2002)
5. Will have voting privileges.
6. Can hold elective office.

Directions For Submitting Membership

After clicking on the submit button a printable version of this form will appear.  Please print out the form and mail to the following address:

Linda Hege
4113 Moss Brook Dr.
Winston-Salem, NC 27127
336-718-6165