Washington State Hands & Voices Membership

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Become a Member in Two Easy Steps

Thank you for becoming and/or renewing your membership with Washington State Hands & Voices!

Annual Memberships are good for one year July 1 thru June 30.

STEP 1: Please fill out the Membership form below.

STEP 2: Follow QR Code or Link at the bottom of page for payment.

Are you a new or renewing member? *

I am a new member

I am renewing my membership

Membership dues: *

Please enter the product number

Parent/family of deaf/hard of hearing child- $25

Deaf/Hard of hard of hearing adults- $25

Student-$25

Professional- $40

Organization- $50

I am requesting a 1 year Family Scholarship- Free

If you are a professional, student, or deaf/hard of hearing adult- what is your role in the community? (This helps us understand our members.)

What is your Name/Family name? (First and Last name) *

What is your Street Address? (example: 2222 Main Street) *

What is your Apartment or Suite Number? (example: Apt. 23B)

What is your City, State and Zip Code (example: Seattle, WA 98001) *

What is your Email Address? (example: signmeup23@gmail.com) *

You will receive The Communicator Newspaper quarterly through the mail. (Pictured below)

Do you wish to be added to the WA State Hands & Voices e-Newsletter as well? (WA State content only)

Yes

Already receive the WA State Hands & Voices e-Newsletter

Required

Are you interested in learning more about serving on the WA State Hands & Voices board? *

Yes

Maybe: Please contact me

Already serving as Committee and/or Board Member

Are you interested in volunteering on a committee or event? *

Yes

Maybe: Please contact me

Already serving on a Committee

What is your race/ethnicity? This will help us with grants for funds to reach and support more families- not required but appreciated! :-). You can. check more than one box. Thank you!

Latinx/Hispanic

Black/African American

Native American/First Nation

Asian/Pacific Isalander

White

Wishes not to answer

Other:

What age(s)/grade(s) is your child(ren) in: (not required) You can check more than one box

0-3

3-5

Grades 1-5

Grades 6-8

High school (9-12)

College

Transition program

Deaf/Hard of hearing adults

I would like to donate along with my membership fees. Please let us know the amount.

Comments or Questions?

THANK YOU!

Be sure to press SUBMIT below to complete Step One.

STEP TWO: To pay for your Annual WA State Hands & Voices Membership please scan the QR code or click this link. https://wahandsandvoices.org/become-a-member/

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Washington State Hands & Voices. Report Abuse

Forms