HCCA’s Forms

The below forms are pertaining to the HCCA’s functions. You may download and complete the form then mail the form to 1815 Ward Ave, La Crosse, WI 54601.

ROOM RENTAL FORM: Use this form for reserving rooms.

Download (PDF, 206KB)

MEMORIAL FORM 1: Use this form for reserving the Center to conduct funeral service or other similar functions.

Download (PDF, 63KB)

SOUL RELEASE FORM 2: Use this form for reserving the Center to conduct soul release service.

Download (PDF, 44KB)

MEMBERSHIP REINSTATEMENT FORM 3: Use this form for those members who wishes to reinstate their classification status from Delinquent to Preferred Active class.

Download (PDF, 68KB)

MEMORIAL FACILITY USAGE POLICY FORM 4: This policy is use along with Memorial Form 1 or Soul Release Form 2. This form must be signed and dated prior to reservation to using the Center.

Download (PDF, 183KB)

PAYMENT PLAN AGREEMENT FORM 5: This form is designed to give HCCA’s members the ability to retain their membership.

Download (PDF, 55KB)


Hmoob Cultural and Community Agency, Inc (HCCA)
1815 Ward Avenue
La Crosse, WI 54601
Phone: (608) 781-5744
Fax: (608) 781-5011


Monday – Thursday: 9:00 A.M. – 4:30 P.M.
Friday: 9:00 A.M. – 12:00 P.M.


Denis Tucker, Agency Administrator

Shoua Thao, Membership Coordinator

A Xiong, Office Manager