Membership Form 2019-20
Membership Information for Dakota HOSA. All information is submitted to HOSA for membership registration.
Membership fee due by: October 01, 2019. Online payment with pay schools or by check: payable to Dakota (NO CASH)
Email address *
DAKOTA High School
First Name *
Your answer
Last Name *
Your answer
Ethnicity *
Cell Phone Number *
Your answer
Competitive Event (N/A if not competing) *
Your answer
Partner or Team Member Names (N/A if single event) *
Your answer
T-Shirt Size *
Parent / Guardian Name *
Your answer
Parent/ Guardian Telephone Number *
Your answer
Parent / Guardian Email Address *
Your answer
Sign up for Remind (81010 @jzemnicka) *
A copy of your responses will be emailed to the address you provided.
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