Hosa Registration Packet

Welcome H.O.S.A 2009-2010 Members! The year is already beginning and that means that HOSA will be starting again! H.O.S.A is a great opportunity for anybody that is interested in the medical field and wants to be a contributing member of our community. H.O.S.A is a yearlong commitment that requires that every member be dedicated to the organization and any activities that we commit to as a group. Below are some activities we have done in the past:  Relay 4 Life (Walk for Cancer)  Metropolitan Ministries Holiday Donation Drives  Monthly Health Awareness  Hospital Volunteering We plan to expand our schedule for the 2009-2010 school year! Here is some more information about H.O.S.A: “HOSA is a national student organization endorsed by the U.S. Department of Education and the Health Science Technology Education Division of ACTE. HOSA's two-fold mission is to promote career opportunities in the health care industry and to enhance the delivery of quality health care to all people. HOSA's goal is to encourage all health occupations instructors and students to join and be actively involved in the HSTE-HOSA Partnership.” -Official HOSA Website

We are currently in the process of getting everything setup for the new school year and that begins with Member Registration. To register for H.O.S.A, please visit our website at: http://slhosa.co.cc . Once signed up online, please sign and return this page to signify that you are committed to HOSA and agree to the following terms of membership:  You agree to attend all scheduled member meetings unless arrangements have been made with either the President or Vice-President.  You agree to pay any and all fees associated with H.O.S.A in order to be registered with the National Association. If any of the above terms are not met, your H.O.S.A club card will be revoked. Print Name: ________________________________ Signature: __________________________________

Date: ________________ Date: ________________

The following must be filled out ONLY if you are not able to submit your application online. Please DO NOT fill this information out unless you did not and are planning not to register online!

Name:______________________________________ (Will also be your username for HOSA Online) Student #: __________________ (Will also be your password for HOSA Online) Grade: ________ 1stPeriod Teacher: ____________________ 6th Period Teacher: _________________ Cumulative GPA: (Please find out from eSembler or Guidance Counselor): _______________ Home Address: ________________________________________________________________________ City: _________________________ State: _______ Zip: ______________ Home Phone Number:(____)-______-____________ Parents Name: ____________________________ E-Mail Address: (Please list a reachable email address as any important meetings updates will be sent by email for ease!) ____________________________________________________________ Have you participated in HOSA before? O YES O NO Are you interested in becoming a HOSA Officer? O YES O NO (Optional) What are some of the things you would like for our HOSA chapter to accomplish this year? _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ If you are a senior, are you interested in getting senior sashes at the end of the year for graduation? O YES O NO

Student Signature: ______________________________________________ Date: _________________ Parent Name: ____________________________________________ Parent Signature: ________________________________________ Date: ___________________ FOR HOSA USE ONLY

Fees Paid? O YES

O NO

Affiliated in Computer? O YES

O NO

Here is some more information about our local HOSA Chapter: The 2009-2010 Officers are: Sponsor: President: Jeffrey Hoschak Vice-President: Kathy Lim We are planning our first community service event which will take place at a local hospital. We are also in the process of securing the following events: November- Metropolitan Ministries Canned Food Drive December- Shriner’s Children’s Hospital January- Fundraising Event May- Relay 4 Life HOSA has a Relay 4 Life team that is open to all members. Relay 4 Life is a community event that supports Cancer by raising awareness and donations for the American Cancer Society. This is an overnight event and more information will be available closer to the event date. For our first meeting, you have an assignment! You have been assigned to a Medical Decisions Board for a university hospital. Today, your decision involves a very common dilemma; one kidney and four patients in complete renal failure, all in need of a kidney transplant. All of the following patients are compatible recipients for the kidney to be transplanted. The kidney donor was a 17-year-old male who was killed in a car crash. The parents have requested that the kidney be transplanted in a teenager. Please have your decision by our first meeting!!!

Mary Greaves 54 Housewife Dialysis: 15 years Transplant waiting list: 7 years Arthritis – Moderate Post-menopausal hormone replacement Hypertension – Moderate Overall health – Fair $46,000/yr Medicaid Has 6 grown kids, all supportive. Husband is reformed alcoholic with stable income and in good health, age 60 Michelle Mantle 35 Former tennis pro Dialysis: 1 year Transplant waiting list: 6 months Multiple sclerosis – 2 years – Moderate Overall health – Fair Net worth – 20 million dollars No insurance High profile patient would bring much media attention to the medical center. Potential exists for financial gain for the medical center, publicity for organ donations. Gary Puckett 19 College student Dialysis: 2 years Transplant waiting list: 9 months Overall health – Good Regularly uses cocaine, other illegal substances have been present in blood specimens. Parents: $120,000/yr Blue Cross/Blue Shield Parents are supportive. Patient resists medical regimen as prescribed by physicians Gerald Ford 43

Auto mechanic Dialysis: 7 years Transplant waiting list: 2 years Overall health – Excellent $25,000/yr Managed care – will cover 50% of costs Has 16 year old son in school who lives in the home. Wife died of Leukemia in 1995