EmailMe Form - Membership Invoice Request

Membership Invoice Request

Thank you for your interest in joining The Hotline Community! This form is for those seeking an invoice to pay by check.

To review levels and benefits, please click here.

The Hotline Community Team will email you with an invoice within one business week from the date of the submission of this form.

Please note: Access to The Hotline Community Platform will be activated when payment is processed by The Hotline. All fees are non-refundable.

Once your payment is processed, you will receive email instructions on how to establish your profile on the platform (and invite your staff to do the same if you are joining as a Direct Service Provider or Institutional Affiliate).

Questions? Please contact membership@thehotline.org. *While we're always happy to assist you, calling The Hotline offices directly will result in longer response times. We recommend emailing us for a quicker reply.

Membership Main Point of Contact (for emails, billing or questions) *
First Last
Main Point of Contact Phone: *
### - ### - ####
Main Point of Contact Email *
Please select the level at which you are joining or renewing. *
Individual ($60/one time fee): for individuals with a personal interest in or connection to the issue, or people working with victims and survivors unable to join at other levels
Direct Service Provider ($200/one time fee): for organizations whose primary mission is to provide direct services to victims and survivors of domestic violence, sexual assault, or other forms of abuse**
Institutional Affiliate ($400/one time fee): Not-for-profit entities that support victims and survivors through indirect services, such as national organizations, state coalitions, and other institutions
**Examples of direct services: crisis counseling and assistance, emergency services, legal assistance, emergency shelter, housing assistance, criminal justice support and advocacy, support groups, etc.
Organization's Name *
Organization's Website: *
Please provide a listing of the direct services your organization provides to victims or survivors of violence or abuse. *
Examples of direct services: crisis counseling and assistance, emergency services, legal assistance, emergency shelter, housing assistance, criminal justice support and advocacy, support groups, etc.
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Thank you for joining The Hotline Community!
The Hotline Community Team will email you with an invoice within one business week from the date of the submission of this form.

Please note: Access to The Hotline Community Platform will be activated when payment is processed by The Hotline. All fees are non-refundable.

Once your payment is processed, you will receive email instructions on how to establish your profile on the platform (and invite your staff to do the same if you are joining as a Direct Service Provider or Institutional Affiliate).

Questions? Please email membership@thehotline.org. *While we're always happy to assist you, calling The Hotline offices directly will result in longer response times. We recommend emailing us for a quicker reply.

Thank you for joining The Hotline Community!