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1. Sign On to HCFANY

* 1. Please indicate if you are acting as an:

* 2. Please choose ONE:

* 3. For individuals/organizations that are signing on, please fill in all fields. If you only wish to sign on to HCFANY's mailing list, you only need to fill in your email address.

4. Please indicate the scope of your organization

5. Please indicate if your organization is