HFMA eStudent Membership

HFMA eStudent Membership

   
If you are not a full-time student, click here for the regular membership application
Congratulations! You are about to take an invaluable step along your career path. Complete this online application, noting that required fields are preceded by an asterisk(*) and boldfaced. When finished, please click on the 'Continue' button located at the bottom of the form.

Please Note: You will be contacted within 48 hours confirming your membership has been processed. Your membership request will be reviewed by our Member Services Team and you will not have access to our members-only section until you receive your welcome email from HFMA. If you need access immediately, please submit this form and then contact Member Services at (800) 252-4362, ext. 2 or memberservices@hfma.org.

   
PERSONAL INFORMATION:
 
Prefix:  
First Name:*
Middle Initial:  
Last Name:*  
Suffix:  
Educational Institution:*  
Expected Graduation Date:*    
Date of Birth:
   
Two phone numbers are required.    
(For all phone numbers, just type 10 characters and press the tab key. The phone number will format correctly.)  
   
Phone:*
Mobile Phone:*
   
Primary/preferred Email:*
Secondary email:*  
*At least one of the email addresses you provide must be a university issued email address ending in .edu
   
Student Postal Address
Address 1:  
Address 2:  
City:  
State:  
Zip:  
   
Home Address (if different)  
Address 1:  
Address 2:  
City:  
State:  
Zip:  
   
Send my mail to:*  
   
One address is required. Please enter a home or school address.  
   
New members are assigned a chapter affiliation based on the location of their preferred mailing address. Upon application acceptance, members may request a chapter transfer by calling (800)252-4362, ext. 2, or emailing memberservices@hfma.org. To learn more about the chapters in your area, visit www.hfma.org  
     
   
HFMA is committed to diversity. Your response is voluntary.  






  
Degree Sought:  
Major: 



 
  
   
Who referred you?
Please specify name and relation to you if possible)
 
   
I affirm that I am a person who, during the academic year, is a full-time college student at an educational institution that maintains a regular faculty and curriculum. This educational institution has an organized body of students at the place where its educational activities are carried on. Alternately, I am full-time intern, resident, or co-op student affiliated with an accredited educational program. Further, I affirm that I am not presently employed in the healthcare finance profession or one of its relevant specialties. I affirm that the information I have given is true to the best of my knowledge and I agree to abide by the HFMA Code of Ethics and the Constitution and Bylaws of the Association. To read the Code of Ethics, go to www.hfma.org/code/
  
Signature:  
Date: