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HOSA Survey 2017-2018
Please enter the following information so we can sign you up for competitions by the deadline! Also, please make sure to pay your dues ($15) by October 20th!
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Name
Your answer
Student ID
Your answer
Grade
9th
10th
11th
12th
Clear selection
Address
Your answer
Race
American Indian or Alaskan Native
Asian
Black or African American
White
Native Hawaiian or Other Pacific Islander
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T-shirt Size
XS
S
M
L
XL
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E-mail
Your answer
Phone Number
Your answer
Do you understand that by completing this survey, you are agreeing to pay $15 to compete? (If you are not sure, please see an officer or Ms. Acheson)
Yes
No
Clear selection
Any allergies or dietary restrictions?
Your answer
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