HOSA Challenge Registration Form HOSA Challenge Registration Form Complete the form below and submit to register your chapter in the 2024 HOSA Challenge. Chapter DetailsChapter name(Required)Number of toolkits needed(Required)HOSA Chapters that include multiple schools may request a toolkit for each school where students will be implementing the challenge. I.e. Copper Country HOSA includes six high schools, so they request six toolkits.Select number of toolkits needed12345678910Number of comfort blanket kits neededAs part of the HOSA Challenge, your chapter can earn activity points by creating no-sew fleece tie comfort blankets for new donor families. Up to 10 free kits will be provided upon request. Select number of comfort blanket kits needed12345678910Mailing address(Required)Please provide a physical mailing address where we can send your toolkit(s) and comfort blanket kits (if requested). Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Number of students in chapter(Required)Social media accountsIf your chapter has a social media account(s) please provide the handle below. Chapter Contact DetailsAdvisor name(Required) First Last Advisor email(Required) Enter Email Confirm Email Advisor phone(Required)May we text you at the number listed above?(Required) Yes No Student contact name(Required) First Last Student contact email(Required) Enter Email Confirm Email Student contact phoneMay we text the student contact at the number listed above?(Required) Yes No PhoneThis field is for validation purposes and should be left unchanged.
