HPGS Membership Application

HPGS Membership Application

Effective 12/01/2026 through 6/30/2026
Contact Name

First NameLast Name
Company / Organization
Upload your company logo here: (if applicable)

Browse Files
Upload logo if joining as a business; you can also upload revised or updated logos here Cancelof
What link (URL) do you want the logo to point to?
e.g., https://acmehomecare.com/
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Website
IN JULY, CHANGE THIS SO IT REFLECTS THE 1/2 PRICE RATE TILL THE END OF THE YEAR.
NOTE: Membership prices are half-off from July 1, 2026 to December 31, 2026.
NOTE: A 4% processing fee has been added if paying by credit card.

Prices valid 1/1/2026 through 6/30/2026
Category - choose one
prevnext( X )
Individual 65 and over paying by CHECK$5.00

Individual 65 paying by card$5.20

Individual under 25 years paying by CHECK$10.00

Individual under 25 years paying by card$10.40

Individual 25 to 64 years paying by CHECK$40.00

Individual 25 to 64 years paying by card$41.60

Company / Organization (includes contact person) paying by CHECK$50.00

Company / Organization (includes contact person) paying by card$52.00

Associate Member (individual of company member) paying by CHECK$25.00

Associate Member (individual of company member) paying by card$26.00

Total $0.00

Debit or Credit Card

Choose from one of the PayPal options to make your payment.