This form is for CREDIT CARDS only.
If you are paying by check or money order as a
new or renewing “individual” member,
please contact HCEA at firstname.lastname@example.org or call 608-441-1054.
Health Care Education Association
Madison, WI 53704-3102
Telephone: 608-441-1054 • Fax: 608-443-2474
Please read the following before you begin:
- This form is for new and renewing Individual memberships only.
- Review the HCEA Membership Types.
- The searchable online member directory will not display any of your alternate contact information (i.e. alternate address, phone number or email address).
- Fields labeled in Red are required in order to process this form.