Join HOSA and PAY for your 2021 -2022 Membership

JOIN HOSA HERE!

This form allows you to register as a 2021-2022 HOSA MEMBER and PAY your membership fee. 

Membership year is from August 1, 2021 – July 31, 2022

Your submitted form will be DELETED for non-payment if your $21 membership payment (membership & non refundable processing fee) is not made at the same

time you submit your form. 

If you have any questions/problems with the form, please contact: Amanda Wilson, schosa@outlook.com

2021 -2022 HOSA MEMBERSHIP Registration/Payment

"*" indicates required fields

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This membership form is ONLY for South Carolina students and advisors.*

Yes, I am a South Carolina student or advisor

No, I am NOT a South Carolina student or advisor.

You are required to pay your $20 membership fee plus $1 non refundable processing fee at the time of this registration*

DO NOT PROCEED WITH YOUR REGISTRATION IF YOU ARE NOT PAYING YOUR MEMBERSHIP FEE AT THE TIME OF SUBMISSION. YOUR SUBMISSION WILL BE DELETED FOR NON-PAYMENT.

Yes, I understand. Once I click on the submit button, I will be directed to PayPal to pay my $21 membership fee.

No, I understand and I will not be able to submit my registration form without payment

Membership Information

Your Name (first & last)*

Who is your HOSA Advisor?*

School*

SCHOOL Email Address*

HOME/PERSONAL Email Address*

Please do not list your school email address here.

Phone Number

Gender*

Male

Female

Race*

Asian

Black or African American

Hispanic

White

Native American

Other

Member type*

Secondary (High School)

Post Secondary (Collegiate)

Middle School

Advisor

Professional

What class are you?*

Advisor

6th Grade

7th Grade

8th Grade

9th Grade

10th Grade

11th Grade

12th Grade

College Freshman

College Sophmore

College Junior

College Senior

2021-2022 SC HOSA Membership is $21/per member. Inculdes a $1 non-refundable processing fee.*

Price: $21.00

Quantity:

Total

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