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Membership Information Update
Please complete all fields so we can verify our records.
Name:
CSR:
Home Address:
City:
State:
ZIP Code:
Home Phone:
Cell Phone:
Office Phone:
FAX:
Email Address:
Your area(s) of reporting:
(Please check all that apply.)
Official
Freelance
Firm Owner
Realtime
C.A.R.T.
Captioner
Scopist
Overflow
Student
Our association is only as strong as its volunteers.
Are you willing to help strengthen HCRA?
Willing to volunteer:
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No
Comments:
Thank you for taking the time to help us update our database. HCRA appreciates you!
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