HCAW Affiliate Member Application

Membership Term:
HCAW memberships run from January through December, but you can join at any time during the year. If you join after October 1, your membership will be valid through December of the following year.

Who Should Join as an Affiliate Member?
Individuals, companies, or other organizations that do not provide home care services to patients but provide support to those who do. Affiliate members are not eligible to vote in membership meetings or elections.

Teamwide Benefits:
While each membership has a designated primary contact, all team members are eligible to access HCAW member benefits.

Company Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Primary Contact Name

First NameLast Name

Primary Contact Email

example@example.com

Primary Contact Title

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Website

Other Memberships

Affiliate Organization Membership Dues

Any company not directly providing home care services to patients but providing support to those who do. Base dues are $500, plus $100 for each additional office in Washington State.

Number of offices in Washington State?

Additional offices

Annual Dues

Payment Method

Pay Online Here

USD

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Additional Members

Please add any additional staff members to receive access to HCAW member communications. Communications include monthly newsletter, advocacy updates, upcoming educational events, QAPI roundtables, and other member news.

You can upload an Excel spreadsheet with columns for employee name, title, and email address or you can manually enter staff below.

Members can opt out of email communications at any time.

Upload Excel Spreadsheet

Add staff members

Dues paid to the Home Care Association of Washington are not tax deductible as charitable contributions for income tax purposes. However, they may be tax deductible as ordinary and necessary business expenses subject to restrictions imposed as a result of association lobbying activities. HCAW estimates that the nondeductible portion of your annual dues – the portion which is allocable to lobbying – is 30%. HCAW’s tax ID# is 91-1102450.

5727 Baker Way NW Suite 200, Gig Harbor, WA 98332

P: 253-525-5161 | E: info@hcaw.org

HCAW Affiliate Membership

Pay Online Here