Application for New Membership

Membership Application Instructions:

In making an application for membership in the Council on Nutrition, I agree to abide by its Constitution and By-laws, help advance its objective and increase its membership. I understand there are annual dues of $150.

How to register:

Registering is a two-step process: First, complete this form about you. After successfully completing this form, you will be shown a link to provide online payment using a credit card on Square. Your registration is not complete until we've received your registration and payment.

About You

About Your Office

About Your Education

More About You and Your Interests

Our mission is to encourage and promote a more advanced knowledge and use of nutrition in the practice of chiropractic for the maintenance of health and the prevention of disease.
Thank you!

Part 1 Successful!

We've received the first part of your registration.
Your registration is NOT complete until payment is received.

Pay Registration Fees Now
We use Square to process payments online.
If you have questions, please call us at 540-252-4733.
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