About YouWelcome! Thank you for choosing to join the INGM. Please complete this form. All fields with a red asterisk are required. After you submit this form you will be taken to a payment page.First Name *Please type your First Name.Last Name *Please type your Last Name.Your Email Address *Your Clinic/ Business Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountryAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweYour Website Address Your Phone Number Membership ClassMembership Type *Which type of membership do you wish to apply for?Physician (Associate) Membership: $100 USD / yearStudent Membership: $35 USD / yearSupporting Membership: $150 USD / yearInterest in Certification Please indicate your interest in Board CertificationCertification in Generative MedicineDiplomate in BioinformaticsDiplomate in Personalized Medicine About Your PracticeSchool *Which ND Program did you/will you graduate from?University of Bridgeport College of Naturopathic MedicineNational College of Natural MedicineBastyr UniversitySouthwest College of Naturopathic MedicineBoucher InstituteCanadian College of Naturopathic MedicineNational University of Health SciencesSupporting MemberWhat Year did you/will you graduate? *Enter n/a if you are a applying for supporting membership.Years in Practice. *Enter a 0 if you are a applying for supporting or student membership.License Number *Please Include State or Province. Enter n/a if you are a applying for supporting or student membership.Professional Associations AANPCANPTerms of Membership *By checking here, I agree to uphold the standards of naturopathic medicine, and understand that any violation of those standards may terminate my INGM associate membership status. I also understand that being an associate member of the INGM does not designate me as a specialist. If applying for supporting membership I understand and agree to the fact that this membership does not constitute endorsement by the INGM in any way or form. I confirm that all information above is true and I understand that my membership will be terminated if I have been found to misrepresent my credentials.I agree to the Terms of MembershipCheckbox Option 1Option 2Option 3Text Fieldset VerificationTo confirm that you are a human, please enter any two digits *For example: 12This box is for spam protection - please leave it blank: