MHF Membership Form

Welcome to this unified Membership Form! By filling out one form each program year (September through August), you can indicate your desire to continue to support Mennonite Healthcare Fellowship and make your contributions at the same time. This form is for collecting and updating the MHF member information database for contact and networking purposes among MHF members. Membership information is available only to MHF staff and membership for the purposes of MHF and is not distributed to outside persons or organizations without your permission. Forms for downloading, reading, and printing are available on the Member Resources page.

Are you applying for a New membership to MHF or are you renewing an existing membership?

New Member
Renewing Existing Membership
Gift Membership Only

Name*

First Last

Spouse Name

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Phone-Home

Phone-Work

Phone-Mobile

Profession*

Choose your profession from the dropdown list. The next field will allow you to specify an "Other" or a specialty.

Profession Other/Specialty

Enter your professional specialty or another profession not on the list above.

Education and Degree

Would you like to add more Education information?

Yes
No

Education and Degree

Current Work / Specialties

Church / Congregation

Mission Statement*

Mennonite Healthcare Fellowship (MHF) is an interdisciplinary community of Anabaptist health professionals, which seeks to nurture the integration of faith and practice, to provide opportunities for dialogue on health related issues, and to address specific needs through education, advocacy, and service.

I support the mission of Mennonite Healthcare Fellowship

Support MHF

In this section, you will have the opportunity to specify your Membership Contribution Category, whether you want to give now or later, and whether you want to spread out your contribution throughout the year.

Contribution Category*

Choose your Membership Contribution Category. Please note that MHF relies on Sustaining memberships to fund our flagship programs such as SET and Stephen Roth Grants. In the following sections, you can register additional memberships for spouse, child, and others. You will also be given the opportunity to give an extra amount beyond the membership category contributions. We encourage Retirees to join at the Professional level. If that is not possible, please choose "Retiree". For Gift Memberships for a student, choose "Student", for all others, please choose "Gift Membership-First Year".

Student or Low-Middle Income Countries - $25
Retiree - $50
Professional Member - $100
Sustaining - $300
Leadership Circle - $500
Gold Leadership Circle - $1000
Apply for Scholarship
Gift Membership - First Year - $50

Additional Members

Check one or more boxes to register additional members, or select "None."

Spouse Membership
Gift Membership - Additional
None

Spouse Member

Fill out this section for spouse membership in MHF.

Spouse Email

Enter spouse's email address.

Spouse Phone-Work

Spouse Phone-Mobile

Spouse Profession*

Choose your profession from the dropdown list. The next field will allow you to specify an "Other" or a specialty.

Spouse Profession Other/Specialty

Enter your professional specialty or another profession not on the list above.

Spouse Contribution Level*

Choose spouse Membership Contribution Level. Below, you can also give an extra amount beyond the category contributions.

Student, Low-Middle Income Countries- $25
Retiree - $50
Professional Member - $100
Sustaining - $300
Leadership Circle - $500
Gold Leadership Circle - $1000
Apply for Gift Membership

Gift Membership

Choose Girt Membership Contribution Category. If name and email is filled in, a membership invitation will be sent to that person. If left blank, Gift Membership will be applied to whoever needs it. Below, you can also give an extra amount beyond the category contributions.

Recipient name

If Gift Membership is to be offered to multiple persons, please email information to info@mennohealth.org.

Gift Recipient Email

Gift Membership Amount

Please give at least $25 per Gift Membership. In the next question, you can give an extra amount beyond the category contributions.

Extra Contributions

In addition to the Membership Category selected, we are grateful for your extra contributions towards the Mission fo MHF through our General Fund.

Extra Contributions

Additional contributions beyond the chosen Membership Category for the MHF General Fund.

Designated Contributions

Contributions collected by MHF, but designated and distributed to another organization.

Mary Jean Yoder Memorial Endowment Fund

The Mary Jean Yoder Memorial Endowment Fund is administered by Mennonite Mission Network in cooperation with MHF and the Yoder family. The interest from this fund is used to provide scholarships and assistance to students in healthcare fields who live in developing countries. You may designate any contribution amount in the field below:

Anabaptist Center for Healthcare Ethics (ACHE)

The Anabaptist Center for Healthcare Ethics (ACHE) is an inter-agency fund for use in projects concerned with healthcare ethics. You may designate any contribution amount in the field below:

Total

$0.00

Payment Method

Echeck (ACH) payment methods will generate a pledge invoice from MHF to your primary email address. Quarterly or monthly payments can be made on contributions of $300 or more.

Paypal
Credit/Debit Card
Echeck (ACH)
Echeck (ACH) quarterly
Echeck (ACH) monthly
Check in the mail
Payment later

Special Note

Although paying online via credit/debit card is convenient for both MHF and the registrant, this type of service incurs a fee of approximately 3% on the amount charged. Please consider contributing the amount needed to cover this fee. Enter the Sub-Total that is calculated into the field below to see your suggested contribution. Then, if you wish to make this additional contribution enter that number into the contribution field.

Contribution Total

Input your contribution total here.

Suggested Amount

Input the suggested additional contribution amount in the donation field below if you wish to help cover card fees.

Fee Contribution

Enter the suggested contribution amount here if you would like to offset MHF's card payment fees.

Final Total

$0.00

Credit Card

Card Details

Cardholder Name