HOSA Challenge Registration Form HOSA Challenge Registration Form Complete the form below and submit to register your chapter in the 2023 HOSA Challenge. Chapter DetailsSchool name(Required)Please list the the name of the school or tech center where your chapter is based. Address(Required)Please provide a physical mailing address where we can send your HOSA Challenge Toolkit. 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. 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 Phone(Required)May we text you at the number listed above?(Required) Yes No
