Who is NHCA? Who can join NHCA? What do we do?

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Welcome to the National Hearing Conservation Association Thank you for your interest in NHCA. We re glad you are considering joining us in our shared mission to prevent hearing loss. Who is NHCA? Who can join NHCA? We are audiologists, engineers, nurses, physicians, industrial hygenists, and others who share a commitment to prevent hearing loss, on the job and off. What do we do? We provide networking resources and professional development opportunities to improve skills, practices, and services of our members. aour annual conference is a great opportunity to keep abreast of new developments in the field and network with leading experts. aeducational opportunities like the one-day Hearing Loss Prevention: The Basics seminar held at the annual conference and other regional seminars held across the country provide low-cost and a timely way to keep skills sharp and stay up-to-date on new developments. aour flagship publication, Spectrum, is a highly respected publication in our field, keeping our members in touch and informed. acommunication tools, like the website and email blasts, put the latest information about legal and regulatory developments, new initiatives, and more in your hands right away. anhca teaching tools, like our Practical Guide pamphlet series and our posters and slides, make your training, motivation, and education jobs easier and more effective. anhca committees and task forces provide the opportunity to network with leading experts while promoting hearing loss prevention through the development of position statements, training and education initiatives, professional recognition efforts, collaboration with related professional organizations, and more. Member status is available to those holding a graduate or professional degree in an area related to hearing conservation, or who have equivalent professional experience as determined by NHCA s Executive Council. Members receive Spectrum, publications and teaching tools, significant discounts on conference and seminar registration fees, hold full voting rights and are eligible to hold office. Associate Members are those who share our interest in hearing conservation, but do not qualify for full Member status. Associate members receive all the benefits of membership, but cannot vote or hold office. Professional Service Provider (PSP) membership is designed for firms providing hearing conservation services. PSP organizations may designate two representatives to receive member benefits, and have special recognition in the NHCA directory along with other benefits. One of the PSP representatives must meet the requirement of Member status. PSP Additional (PSPA) is available to employees of PSP members not eligible for Member or Associate status and who are not already designated as the secondary representative. PSPA s receive Spectrum, a member certificate, access to the Member s Only section of the website and email broadcasts, but cannot vote or hold office. See PSP Benefits for more details. Commercial Members (CM) are firms making or distributing products related to hearing conservation. Along with Member-level benefits, Commercial membership includes discounted exhibit space at NHCA conferences and meetings, advertising space in Spectrum, and more. CM Additional (CMA) is available to employees of Commercial members not eligible for Member or Associate status and who are not already designated as the secondary representative. CMA s receive Spectrum, access to the Member s Only section of the website and email broadcasts, but cannot vote or hold office. See Commercial Member Benefits for more details. Student membership is available to individuals pursuing a degree in a field related to hearing conservation at least half-time in an accredited educational institution. Student members receive all of the benefits of membership, but cannot vote or hold office.

National Hearing Conservation Association PSP & Commercial Member Benefits PSP Member Benefits A Professional Service Provider (PSP) Membership applies to any Company (profit or non-profit) regularly providing Hearing Conservation Services. At least one member of the PSP Company must be eligible for a full regular membership. PSP s are expected to follow standards of good practice and conduct becoming of an NHCA professional member. PSP Benefits include: a In addition to the one designated full member, a PSP may include one Professional Service Provider Associate (PSPA) as a secondary representative of the Company at no added cost. a Listing within the NHCA Website under Find a Service Provider for anyone seeking Hearing Conservation Services. The listing displays the Company Name, Member Designate, Phone Number, E-Mail and a link to the Company Website. The listing will be posted for any State in which the Company does business. a PSP s have a ½ day Workshop as part of the Annual NHCA Convention held around the Country. PSP s registering for the full day of Workshops can attend the PSP Workshop for free and need only pay ½ the normal Workshop Registration. a PSP s are encouraged to use their NHCA Memberships and the NHCA Logo as a promotional tool for their business. a PSP Member Certificate a 10% discount on Educational Materials Commercial Member Benefits Commercial membership offers access to early adopters and leaders in hearing conservation. Commerical members receive a package of benefits including: a Two designated representatives, each receiving all of the benefits of Member status. a One FREE website advertisement posted during the month of your choice on the homepage of the NHCA website. Advertisements MUST be 600 x 300 pixels MAX / GIF (72 dpi or larger) a Company logo and 75 word descriptor posted on NHCA website during membership year. a Free advertising. Two half-page Spectrum ads per year and a half-page ad in the NHCA Directory are provided to Commercial members at no additional cost. a Significant discounts on exhibit space at NHCA conferences and seminars. a Association Sponsorship opportunities, bundling the best available exhibit, conference registration, and support offerings in a single convenient package. a CM Additional members get a discounted membership rate as an employee of the Commercial Member who is not eligible for Member or Associate status and who is not already designated as the secondary representative. Most importantly, NHCA membership provides you privileged access to leading experts, early adopters, and trendsetters in our field. Networking opportunities alone with NHCA members are worth the cost of membership. You can t afford not to participate with NHCA - it s important to your business to be here!

National Hearing Conservation Association Code of Ethics Preamble The goals and purposes of the Association demand the highest standard of integrity and ethical behavior on the part of its members. This Code of Ethics has been developed to identify some fundamental principles that should be honored by Association Members. These principles should not be viewed as exclusive, but represent the general standards of ethical practices expected by the Association and its members. Any act that is in violation of the spirit and principles of the Code of Ethics shall be viewed as unethical practice. Members share in the responsibility to advise the Association s Ethical Practice Committee of instances of possible violation of the Code. Principles of Ethics Members shall ensure their education and training is consistent with the range of professional services they may provide. All categories of members shall refrain from misrepresentation of credentials and other qualifications. Professional members shall not abuse the prerogative of delegation of services and shall ensure that appropriate supervision of nonprofessionals is provided. Services provided, shall, at minimum, conform to standards adopted by the Association, or, in the absence of such standards, shall conform to standards established in federal and state regulations as they may apply, and to commonly accepted standards of professional practice. The standards developed by this Association will always be at least as rigorous as those required by federal and state regulatory agencies. Communications to the public or other purchasers of services must be accurate. They shall not convey false, unsupported, deceptive, or misleading information. Members shall honor their responsibilities to the public or other purchasers of services or products, their profession and their relationships with colleagues and members of related professions, and shall not misrepresent the stated mission, goals, or credentials of this Association. Revised and accepted by the NHCA Executive Council June 8, 1990.

NHCA Email: nhcaoffice@hearingconservation.org Web: www.hearingconservation.org MEMBERSHIP APPLICATION TYPE OF MEMBERSHIP AND ANNUAL DUES: Professional Information: Your profession: q Audiology q Industrial Hygiene q Engineer q Safety q Physician q Nursing q CAOHC Technician q Law q Risk/Loss Control q Other: q Check payable in US funds to NHCA q Visa q MasterCard q AMEX Company/Organization Mailing Address Students: Anticipated graduation date If Commercial, name of 2nd representative Education: Certification, Accreditation, and/or Experience in Hearing Conservation: What is your current involvement in hearing conservation? *If Commercial, please attach a 75-word description of your business Name/Title City/State or Province/Postal Code/Country Your main employer: q Industry q OHC Service Provider q Government q Military q Law Firm Background Information: q Union/Organized Labor q Clinical/Health Services q Academic/Research Facility q Insurance Provider q Other: Education Foundation Donation (Optional) NHCA Scholarship Foundation Contribution Optional Contribution to the NHCA Scholarship Foundation (Contributions are tax deductible Payment Information: Phone/Fax/Email/Website How did you hear about NHCA? q Colleague q Website q Conference exhibit q NHCA brochure q Print publication Please list publication: q Other $ q Member, $190 Available to those who hold a graduate or professional degree in a discipline related to hearing conservation or who have the equivalent via professional experience. q Associate, $190 Available to those with an interest in hearing conservation who do not meet the requirements of a member. q Professional Service Provider (PSP) Member, $450 (PSP s MUST complete the application on page 5) Available to organizations providing hearing conservation services. Each PSP may designate two representatives, at least one of whom must meet the requirements of a member. q Professional Service Provider (PSPA) Additional, $90 (PSP s MUST complete the application on page 5) Available to employees of a PSP member who is not eligible for member or associate status and not already designated as the secondary representative. q Commercial Member, $985 Available to organizations that manufacture or distribute products for us in hearing conservation programs. Each commercial member may designate two representatives. q Commercial Member Additional, $90 Available to employees of a PSO member who is not eligible for member or associate status and not already designated as the secondary representative. q Student Member, No Charge Available to individuals pursuing a degree in a field related to hearing conservation who are enrolled at least half-time in an accredited educational institute. ***Student applicants must have your advisor sign this application Printed Name/Title Phone MEMBERSHIP DIRECTORY OPT-IN: Signature and Date q OPT-IN to receive emails from NHCA and copies of Spectrum as email attachments. q OPT-IN to have name and mailing address supplied via onetime-use labels to commercial members of NHCA as well as third parties that have interests, mission, and vision that are consistent with those of NHCA; entrust decision to provide one-time-use mailing labels to NHCA administration. q OPT-IN to allow NHCA to provide name, mailing address, and email address to commercial members of NHCA as well as third parties that have interests, mission, and vision that are consistent with those of NHCA; entrust decision to provide one-time-use mailing labels to NHCA administration. The above choices accurately reflect my intentions in terms of permitting NHCA to contact me and to share information about me: Signature Card # Exp. Date: CVC Code: CC Billing Address: Signature of Cardholder: If accepted for membership in NHCA, I agree to abide by the NHCA Code of Ethics: _ *Your membership dues may be deductible as ordinary and necessary business expenses, but are not deductible as charitable donations for federal income tax purposes. *Privacy Policy: NHCA only collects personally identifiable data such as your name, address, telephone number, and email address when you voluntarily submit it to NHCA as part of your membership application or renewal. This information may be used by the NHCA administrative office as a means to contact you to obtain clarification of information. Further, the information will be used to send any materials you have requested. With your permission by OPTING IN, you may be contacted by the NHCA administrative office to provide you with information that the NHCA Executive Council feels may be of interest to you, including copies of Spectrum, the NHCA s quarterly publication as well as other mailings, or to help improve this improve this site. Unless you OPT IN, your information will not be transferred to a third party outside of NHCA by means of one-time- use mailing labels. Your information in electronic format will not be shared with a third party outside of NHCA unless you OPT-IN. NHCA may use your information in aggregate for performing demographic or marketing studies.

NEW MEMBER APPLICATION - PSP MEMBERS ONLY Please Note: This application will be reviewed by the PSP Review Committee within one week of your application submission being received. You will receive a confirmation email with the membership application status once the committee has reviewed this information. PSP Applicant Information: Applicant Name: Degree(s): Contact Phone: Email Address: Profession: q Audiologist q Physician q Other: Position within PSP Company: q Officer q Employee q Other: PSP Additional Member Application Information: Applicant Name: Degree(s): Contact Phone: Email Address: Profession: q Audiologist q Physician q Other: Position within PSP Company: q Officer q Employee q Other: PSP Company Information: PSP Company Name: Address: City: State/Province: Zip/Postal: Website: How will the NHCA Logo be displayed? q Website q Letterhead q Advertising Materials q Other Services Offered: q Mobile Hearing Testing q Noise Surveys q CAOHC Training q Company Educational Training in Hearing Conservation q Professional Supervisor (COAHC) q Hearing Conservation Program Evaluations q Other: Application Submission Checklist: q REQUIRED: New PSP Applicants MUST provide two letters of recommendation from clients or other PSP Members (PSP Members cannot be part of the review committee.) *If you do not have a company website you must provide a sample of the following. Please send to: nhcaoffice@hearingconservation.org or fax to 303-458-0002 q Letterhead q Advertising Materials/Brochures q Professionals on staff: q Audiologist q Physician q CAOHC Technician q Administrators q Other: q Manual Audiometric Test Technique is within the ANSI/ASA S3.21-2004 (R2009) guidelines q Audiometric Test Environment meets or exceeds OSHA requirements: q YES q NO q With the exception of an Audiologist or Physician, does your company require audiometer operators (manual or micro) to be CAOHC certified? q YES q NO q Does the review of audiometric data require an Audiologist or Physician to review STS s and other problem losses? q YES q NO Payment Information (Note: Your payment will not be processed until the PSP Review Committee has approved your application) q Visa q MasterCard q AMEX q Check CC #: CVC Code: Expiration Date: CC Billing Address: Cardholder Signature: If accepted for membership in NHCA, I agree to abide by the NHCA Code of Ethics: Signature and Date NHCA Email: nhcaoffice@hearingconservation.org Web: www.hearingconservation.org