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* 1. Are you referring new members as an individual Member of HPNA or on behalf of an HPNA Local Chapter? (choose one)

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* 2. Your Name

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* 3. Your Email Address

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* 4. Name(s) and Email address(es) of your referred member(s)

Thank you for your submission. HPNA will use this information to track the referred members and you will receive credit for any that join before October 31, 2022.

Feel free to reach out to HPNA at info@hpna.org to check the status of your referrals. 

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