Advisor's Name*
Email Address*
School*
Billing: Name*
Billing: Street Address*
Billing: City/State/Zip Code*
Registration Fees
Please note: This does NOT register you for the conference. It only allows you to pay your registration fees with a credit/debit card. There is a $3 processing fee PER REGISTRATION, and if applicable, a $1 processing fee PER STUDENT "Activity/Option" and a $2 processing fee PER ADVISOR "Activity/Option".
Student
Registration Fee, plus $3 processing fee per registration.
Price: $93.00 Quantity:
Advisor
Registration Fee plus $3 processing fee per registration.
Price: $93.00 Quantity:
Chaperone/Guest
Registration Fee plus $3 processing fee per registration.
Price: $93.00 Quantity:
HOSA Options/Activities- STUDENTS
HOSA 101
Local Member
Price: $26.00 Quantity:
HOSA 102
Advanced Leadership
Price: $26.00 Quantity:
HOSA 201
Chapter Officer
Price: $26.00 Quantity:
HOSA Options/Activities- ADVISORS
HOSA 401
New Chapter Advisor
Price: $52.00 Quantity:
HOSA 501
Advance Chapter Advisor
Price: $52.00 Quantity:
Your Total
$0.00
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2018 State Conference Registration Credit Card Payments

This form ONLY pays your registration fees. It does NOT register you for the conference.

Advisor's Name*
School*
Billing Name*
Billing Email Address*
Billing Address*
Street Address City State ZIP Code
Students
Price: $83.00 Quantity:
Student Registration Fee
Advisors
Price: $83.00 Quantity:
Advisor Registration Fee
Chaperone/Guest
Price: $83.00 Quantity:
Chaperone/Guest Registration Fee
Administration (change) FEE
Price: $25.00 Quantity:
If you are making changes after the published deadlines.
Your Total
$0.00
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Archive for category: Payments