Thank you for your interest in membership in the Mile High Health Alliance! We welcome you to join us in our mission of “Achieving Better Heatlh through Collaboration!”

Organizations and individuals may apply for membership in the Alliance. All organizational members except ex-officio members will have a seat on the Board of Directors, regardless of the organization’s size. Individual members will not hold Board seats.

Read the MHHA Membership Agreement.

For organizational applicants, please have the following information available when filling this form, as it will not be possible to save a partially completed application and return to it later:

  1. The names and contact information of persons in your organization whom you would like to designate as your Voting and Alternate Member on the Mile High Health Alliance Board of Directors (not applicable for applicants for ex-officio membership). Either of these persons may also be the principal contact person for your organization.
  2. Your organizational mission statement, if you have one.
  3. Knowledge of your organization’s total annual revenue, to specify the appropriate membership tier in the Mile High Health Alliance. You will not have to report this information to the Alliance.
Fields marked with an * are required

Address:

Principal Contact Person:

For organizational applicants, please designate a Voting Member and an Alternate Voting Member for the Mile High Health Alliance Board of Directors, if known at this time.

Note that individual members and ex-officio members of the Alliance are non-voting members and need not make these designations.

Voting Member:

Alternate Voting Member:

Please note the following:

Regular membership tiers are based on organizational revenue.
Tax-exempt organizations may use total annual revenue from IRS Form 990, line 12 to determine their membership tier.
Tax-paying organizations may use total gross annual revenue to determine their membership tier.
If your organization operates in multiple locations, your may consider its organizational revenue specific to its operations in Denver.
Governmental organizations are in a unique membership tier with reduced membership dues.
Individual and ex-officio members are non-voting members and are not required to pay membership dues, but they are encouraged to make a donation to the Alliance. The suggested donation for ex-officio members is $500/year.
It is not necessary to report your organizational revenue to the Mile High Health Alliance.

If your organization faces significant difficulty paying the membership dues indicated above and you are requesting a reduction, please explain your circumstances here for the consideration of the Mile High Health Alliance Executive Committee. Please be sure to specify which membership tier your organization would normally fall under based on its organizational revenue, and details of the hardship that does now allow your organization to pay this amount.
If you are applying for an ex-officio membership, please explain briefly why you feel this type of membership is appropriate for your organization.

Please note that the Colorado Nonprofit Development Center (CNDC) is the fiscal partner of the Mile High Health Alliance, and will receive your payment on behalf of the Alliance.

Please make checks for the membership dues indicated above, payable to

“CNDC, DBA Mile High Health Alliance”

and send directly to:

Colorado Nonprofit Development Center

789 Sherman Street, Suite 250

Denver, CO 80203

If your organization requires an invoice in order to make your payment, please contact Denise de Percin, Executive Director of the Mile High Health Alliance, at Denise.dePercin@dhha.org.