FHCi Family Membership Agreement

Family Last Name*
Number of participating children*
List FHCi file numbers (if known)
HP Supervisor's Name*

First NameLast Name
Please enter your HP Supervisor's email address below.*
Did you enroll your family and begin program participation prior to January 1, 2015?*

YesNo or not sure
Anticipated Program Completion Date

MonthDayYear
Your email address*
Please Choose One*

USACanadaOther international
State (USA)*
Canada - please select Province*
If not USA or Canada, please enter country*
Please Join Our Email List!

FHCi sends occasional email announcements to our Member Families. At this time, we would like to ask you to enroll yourself in that list in order to receive those important notifications. Please be assured that your information will not be shared with others, and that our communications with you will be kept to a minimum.
Yes, I would like to add myself to the FHCi Member Families email list.*

Continue
Please CLICK HERE and follow the steps to subscribe. When you have completed your email enrollment, please return to this form to continue.

Thank You!!

Please read the 2017 FHCI Membership Agreement for current families below. When you have completed reviewing the information, please go to the next page to sign the form and complete your membership with FHCi.

If you are unable to view the document, please CLICK HERE to view the pdf via your browser.

I have read and understand the terms of the 2017 FHCI Membership Agreement - current families.*

Yes
Your Name*

First NameLast Name
Signature*
Date*
Would you like to make a one-time donation to FHCi to cover your family's membership?

Yes, I'd like to make a one-time donation to FHCi. (We suggest $35.)No thanks.
I'll make my donation via (choose one)

PayPal (you do not need a PayPal account)Check
FHCi Lifetime Membership (per EXISTING family) - Please enter donation amount in the space provided.

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USDSuggested donation: $35.00
Checks should be made out to FHCi. Please include the following info ON YOUR CHECK:
- Your HP Supervisor's name
- Your Family's Last name
- Your Family's email address
Mail checks to:
- FHCi
- 1614 Harmon Place, Suite 204
- Minneapolis, MN 55403
Should be Empty: