Membership

Why Be a Member?

Our members include families, DHH adults, professionals, and other organizations who are all working towards ensuring successful outcomes for children who are DHH. We invite you to join today and help us ensure that a non-judgmental voice remains available to families.

Take a look at the many benefits of membership.

Renewing members: We appreciate your membership!

If you are renewing, please know that your continued membership supports our work towards ensuring successful outcomes for children who are DHH and making certain that a non-judgmental voice remains available to families.

Instructions

To become a member/renew your membership, please fill out the form below and submit your membership payment via PayPal.

If needed, you may download our membership form and mail your completed form and check to our business address (at bottom of page).

Please enable JavaScript in your browser to complete this form.

Membership Type

Do you already have a membership? *

• No, I’m new!
• Yes
• Yes, but want to update my contact info

Layout

Member Type *Parent – $25.00Other Family Member – $25.00DHH Adult – $25.00Student – $25.00Professional – $40.00Organization/Agency – $50.00

Annual membership donation depends on member type

Additional DonationSelect amount to donate…$10$20$50$100$1000

General Information

Name *

First

Last

Layout

Phone *

Email *

Additional Email

You may enter a second email if another person would like to receive our e-blasts and communications.

Address *

Address Line 1

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

County *Select County…AlamedaAlpineAmadorButteCalaverasColusaContra CostaDel NorteEl DoradoFresnoGlennHumboldtImperialInyoKernKingsLakeLassenLos AngelesMaderaMarinMariposaMendocinoMercedModocMonoMontereyNapaNevadaOrangePlacerPlumasRiversideSacramentoSan BenitoSan BernardinoSan DiegoSan FranciscoSan JoaquinSan Luis ObispoSan MateoSanta BarbaraSanta ClaraSanta CruzShastaSierraSiskiyouSolanoSonomaStanislausSutterTehamaTrinityTulareTuolumneVenturaYoloYuba

Child's Information

Layout

Child's Name *

Birthday *

MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Additional Children

• Add additional children who are deaf or hard of hearing

Layout – Additional Children

2nd Child's Name

2nd Child's Birthday

MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

3rd Child's Name

3rd Child's Birthday

MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Additional Information

Layout

How can we support YOU?

I'm interested in helping by…

• Writing an article
• Hosting a gathering for families
• Marketing CA Hands & Voices
• Grant Writing/Fundraising
• Translating information into other languages
• Other, please contact me

Primary Language *EnglishSpanishASLOther

You may select multiple languages

Ethnicity *Select from list…African American / BlackAsianHispanic / LatinoNative Hawaiian / Pacific IslanderNon-WhiteWhiteUnknown / DeclineOther

This information is helpful for grant writing, but is purely optional

Referred by *Select from list…Another ParentAudiologistENTEarly Start (0-3 years old)School District (3+ years old)LEAD-K Family ServicesHands & Voices HeadquartersHearing Coordination Center (HCC)Self-Referral / WebsearchOther

Submit Payment via PayPal

Layout

Total Amount

$0.00

We process our payments through PayPal. Once you click Subscribe, you will be taken to PayPal to complete your membership application and pay the total amount listed here. You will then be returned to our site.

Subscribe