Membership Registration Form
Thank you for your interest in becoming a Heartbeats & Hands 540 member. Complete this registration form to confirm your membership. Our one-time, $20 membership fee covers the cost of your HH540 member's T-shirt. After you complete this form, an invoice for the membership fee/t-shirt will be emailed to you from Paypal.
Full Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Phone Number
*
Volunteering Areas of Interest
*
Would love to!
Would like to.
Wouldn't mind helping.
Not this area.
Adult Literacy Programs
Children & Youth Educational Programs
Domestic Violence & Sex Trafficking Initiatives
Healthcare Initiatives
Homelessness & Food Insecurity Initatives
Senior Citizens' Care Programs
Environmental Causes
Preferred Day(s) of Week to Volunteer
*
Best time for me
No Preference
Not Available
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Preferred Time(s) of Day to Volunteer
*
Best time for me
No Preference
Not Available
Mornings
(Start time before 10:30 am)
Mid-day
(Start time near 12 noon)
Afternoons
(Start time near 2pm or later)
2023 Membership T-Shirt
T-Shirt Size
*
Size
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Adult XXX-Large
T-Shirt Delivery Preference
*
Select One
Pick T-shirt up at next event
Mail T-Shirt to me ($5.55 cost)
Any Special Comments (Please let us know any additional information about you or refer a friend below.)
Submit Form
Should be Empty: