Million Dollar Club Membership

Million Dollar Club Membership

Complete the form below to sign up for your 2024-2025 membership as an individual or a business. Fees are only $100 for the entire year paid in one payment, or pay $10 monthly. There are also higher levels you can join. Submit your profile photo or logo to be displayed on Facebook and Website. All monies will go toward helping people in the community through Mississippi Heroes as we build wheelchair ramps and help Caregivers take care of their loved ones. We will have prizes for those who recruit the most people - so start signing people up and help us reach $1,000,000 in donations!
Name*

First NameLast Name
Recruited by (help them win prizes by putting their name-they must be a member to win any prizes):*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birth Date - if we mail out Birthday cards - year not necessary.

MonthDayYear
How did you hear about us?

A Friend or colleaugeSocial Media PostMedia or FlyerOther

MEMBERSHIP LEVELS

$100 Elite MembershipYou will be listed on the website and Facebook as a Million Dollar Club Premiere Business or Member!

$100.00

$250 Premiere MembershipYou will be listed on the website and Facebook as a Million Dollar Club Elite Business or Member! (this includes 2 memberships).

$250.00

$500 Platinum MembershipYou will be listed on the website and Facebook as a Million Dollar Club Platinum Business or Member! (This includes up to 3 members).

$500.00

$10 Monthly Elite MembershipYou can pay a $10 monthly fee for the $100 Premiere Membership - you will be listed on the website and Facebook page as a Million Dollar Club Premiere Member! You will get a monthly notice via Square for your payment. Contact us for other ways to pay.

$10.00

Total

$0.00

Credit Card

Preferred way to contact

PhoneEmailAny
Membership Rules
1. Membership is available to anyone 21 years of age or older.

2. You promise to treat club members with mutual respect and invite others who will do the same.

3. You agree to have fun.

4. No socials or events are mandatory, just an added benefit to being a member of the MS Heroes Million Dollar Club.
I have read, understood, and accepted the rules for membership.
Type name as you would like listed on website and Facebook.
Once you submit your application, we will contact you shortly to complete your membership application. Thank you for being part of the MDC - Community Members Making a Difference!

We Look Forward To Seeing You Soon!!
Upload photo for profile picture for Facebook and Website

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Million Dollar Club Membership

Credit Card

Membership Rules