Application

*Please copy and paste the following into a word document and print out

HOSA Membership Application – 2012/2013

PLEASE COMPLETE IN FULL. USE BLUE OR BLACK INK ONLY. PRINT LEGIBLY.

STUDENT NAME:_____________________________________________________

ADDRESS:___________________________________________________________

CITY:______________________________________ ZIP CODE:________________

CONTACT TELEPHONE #:________________________

CELL PHONE #:________________________  EMAIL:_____________________________________________________

Student ID #:________________

How many years have you been in HOSA?_____________

GENDER: MALE FEMALE

CURRENT GRADE LEVEL:

9^th 10^th 11^th 12^th 

LIST YOUR SCHEDULE 

1. 5.
2. 6.
3. 7.
4. 8.

** Go to Mr. Mitchell’s website and click on links.  Scroll down and click on HOSA Competitive List and Guidelines.  Pick the top three competitions you are interested in.

1)____________________________________________________________

2)____________________________________________________________

3)____________________________________________________________

Describe briefly your reasoning for selecting HOSA as an organization to participate in…

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

___________________________________________________________________

Describe briefly all previous experience with HOSA (if applicable).

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

I have been to the HOSA National and Texas Websites and have read all eligibility rules. By signing below, I agree to abide by such or be subject to the penalties of the organization. I also understand RRISD UIL rules of eligibility and understand those.

Student Signature______________________________________Date__________

Parent Signature_______________________________________Date__________

Please return this completed application along with all required documentation and a MEMBERSHIP FEE OF $30.00 (This includes your national, state, and local dues). Please make your check payable to RRHS-HOSA.

Your documents and fees should be in a sealed envelope and returned either to Mrs. Cooper or Mr. Mitchell in 207. 

ALL APPLICATIONS FOR THE 2012-2013

 SCHOOL YEAR WILL 

BE DUE NO LATER THAN

FRIDAY, SEPTEMBER 21, 2012 AT 4PM!