2025 Million Dollar Club Membership

Join the Million Dollar Club

Complete the form below to sign up for the 2025-2026 as an individual or a business. Donations 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! We also have a new phone app. Please download off the app store "MississippiHeroes" :)
Your Information
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
Payment Information
Select if you previously paid via Check or Cash, or if you have been gifted a membership (subject to verification). If paying by Debit/Credit card, continue below.

I paid via Cash.I paid via Check.I was gifted a membership.

Million Dollar Club Levels

$100 Elite You will be listed on the website and Facebook as a Million Dollar Club Elite Business or Individual.

$100.00 for each year

$250 Premiere You will be listed on the website and Facebook as a Million Dollar Club Premiere Business or Individual.

$250.00 for each year

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

$500.00 for each year

$10 Elite - Monthly Donation$10 Monthly Donation for Elite Status - you will be listed on the website and Facebook page as a Million Dollar Club Elite!

$10.00 for each month

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Preferred way to contact*

PhoneEmailAny
Acceptance of Terms
1. Available to anyone 21 years of age or older.

2. You promise to treat all individuals 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 part 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.
Upload photo for profile picture for Facebook and Website

Cancelof
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!!
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Join the Million Dollar Club

Your Information

Payment Information

Acceptance of Terms