Name Tag Request
New Members and New Transfers-in to HCR from other Regions, and their Affiliate Members (spouse, significant other, relative, or friend) are eligible for a free name tag within one year of the member's transfer-in date.

After one year, you may purchase a name tag through The access link is “Purchase Luggage tags and Replacement Name Tags” ,which is immediately adjacent to the “Complementary Name Tag” link on the home page.

Please submit the form once for each new member or new affiliate member.

NOTE: If you have problems entering data into this form, please try another browser. If you continue to have issues, please contact
Date you joined PCA and HCR, or transferred into HCR from another Region *
First Name *
Last Name *
PCA Membership ID *
Email Address *
Mailing Address *
City *
State *
Zip *
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