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Please supply all information below or Download the membership application here (.docx). Approval of your application is subject to review by the Membership Committee.
Please confirm that you are applying for new membership. If you are renewing, please go to memberships.
Please use the following format: 123-456-7890
Formats: 12345 or 12345-1234
Please summarize in 100 words or less the nature of your business and include where the company is headquartered, how long in business, etc.
Please tell us in 100 words or less why you or the company would like to be a part of HSDA.
References or Recommendation
In order for you or the company to be considered for HSDA membership approval, you must either (1) provide 3 references or (2) have a recommendation from a current HSDA member.
I have 3 references.
I have a recommendation.
For each reference, please provide the following: (1) Name, (2) Company Name, (3) Phone Number and (4) E-mail Address.
Please provide the following: (1) Name, (2) Company Name, (3) Phone Number and (4) E-mail Address.
Diversity Supplier ($260.00)
Hospital System ($520.00)
Major Corporation ($1850.00)
Payments for membership dues are not processed with your application. We only collect dues on approval.
The HSDA is a not for profit 501 (C) 6 corporation focused on education and awareness of supplier diversity within the healthcare supply chain and does not extend any promise of business to its members. Nothing in any HSDA printed materials or verbal interactions should be construed to imply a promise of business. All officers and directors represent their affiliated organizations.