EmailMe Form - Membership Invoice Request

Membership Invoice Request

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

To review membership levels and benefits, please click here.

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

Please note: Your membership with the Hotline will be activated when payment is processed by The Hotline. Membership is considered active for one year from receipt of payment (e.g., June to June). Membership with the Hotline is non-refundable.

Hotline Membership has moved to a new virtual community platform! Once your payment is processed, you will receive email instructions on how to establish your profile in the new virtual community 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.

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 membership level at which you are joining or renewing. *
Individual Membership ($119): 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 ($419/year): 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 ($839/year): for organizations and entities that do not provide direct services but support victims and survivors in other ways such as national organizations, state coalitions, educational institutions, or corporations
**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 or Company Name *
Organization's/Company'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 being a member of the Hotline!
The Hotline Membership Team will send an invoice to the email address of the main point of contact listed above within one business week from the date of the submission of this form.

Please note: Your membership with the Hotline will be activated when payment is processed by us.

Membership is considered active for one year from receipt of payment (e.g., June to June). Membership with the Hotline is non-refundable.

Hotline Membership has moved to a new virtual community platform! Once your payment is processed, you will receive email instructions on how to establish your profile in the new virtual community and invite your staff to do the same if you are joining as a Direct Service Provider or Institutional Affiliate.

If you have further questions, please email us at membership@thehotline.org

Thank you for being a member of the Hotline!