Wisconsin HOSA Alumni - Update Your Contact Info!

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Calling All Wisconsin HOSA Alumni Members! We are looking to share upcoming opportunities with you. Help us stay in touch by ensuring we have your most current contact information!

Also please indicate what opportunities you are interested participating in as an Alumni Member this year. Your interests will help us continue to grow our Alumni Division. Share this form with other Wisconsin HOSA Alumni members you may know!

Direct any questions or concerns by emailing contactus@wihosa.org.

First Name *

Last Name *

Type of Alumni *

Undergraduate Student

Graduate Student

Health Professional or Health-Related Professional

Educator

Other:

Current Employer/School *

Title *

Communication

Email *

Phone *

Address

Street *

City *

State *

Zip Code *

HOSA Affiliation

High School Attended/Chapter Affiliated *

Graduation Year *

Postsecondary School Attended

Graduation/Expected Graduation Year

Did you attend a state or national/international leadership conference? *

Yes

Did you participate in the Competitive Events program? *

Yes

If yes, which event(s) did you compete in?

Alumni Registration

If you have not already registered as an Alumni Member with HOSA - Future Health Professionals, use the link provided in the confirmation upon submitting this form to officially register as an alumni member today!

Already registered as an Alumni Member with HOSA - Future Health Professionals, but needed to update your contact information? Wisconsin HOSA can assist in this process, please select one of the statements below... *

Yes, I confirm that I am already a registered Alumni Member of HOSA and request Wisconsin HOSA share my current contact information with HOSA - Future Health Professionals to update in the alumni database.

Yes, I confirm that I am already a registered Alumni Member of HOSA. My contact information is already accurate in the alumni database and I do NOT request Wisconsin HOSA to share my contact information with HOSA - Future Health Professionals at this time.

No, I am not already a registered Alumni Member of HOSA and will complete the Alumni Registration with the link provided upon submitting this form.

Required

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