Membership Registration Form

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 NameLast Name
Address

Street Address

Street Address Line 2

CityState / 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*

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)

T-Shirt Size*

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.)
Should be Empty:

2023 Membership T-Shirt