This application is designed for prospective and/or current RCHAL members requesting financial assistance in the form of an annual Membership Dues Waiver. This form must be completed/resubmitted by the applicant annually and reviewed by the Board.
Information provided does not necessarily qualify or disqualify you. Please answer to the best of your ability.
Please note....all information disclosed will remain confidential, only being viewed by the members of the RCHAL Board.