Membership

Join HerRelief Jamaica in expanding access to healthcare, humanitarian assistance, disaster recovery resources, education, and community support.

Complete the membership application below to express your interest in joining our organization. Please provide all applicable information. Our team will review your application and contact you regarding the next steps.

Please enable JavaScript in your browser to complete this form.

Name *

First

Last

Date of Birth

MM/DD/YYYY

Street Address

City/ State/ Parish

Country/ Postal Code

Telephone

Email *

Occupation/ Profession

Employer/ Organization

Emergency Contact Name

Emergency Contact Telephone

MEMBERSHIP TYPE & ANNUAL FEE *

• Individual Member – US$100 / J$16,000 annually
  For individuals who support the mission of HerRelief Jamaica and wish to participate in service, outreach, fundraising, and volunteer initiatives.
• Professional Member – US$150 / J$24,000 annually
  For individuals who hold a current professional license, certification, or recognized credential and wish to contribute their professional expertise to HerRelief Jamaica’s missions, programs, or organizational activities.
• Student / Young Adult Member – US$25 / J$4,000 annually
  For students and young adults interested in community service, humanitarian outreach, leadership development, and volunteer activities.
• Corporate / Business Member – US$500 / J$80,000 annually
  For businesses, professional practices, and organizations supporting HerRelief Jamaica programs and employee participation.
• Lifetime Member – US$1,000 / J$160,000 one-time contribution
  For individuals making a long-term commitment to the organization and its humanitarian mission.

Select one membership category.

AREAS OF INTEREST

• Medical Missions
• Dental Missions
• Mental Health & Wellness
• Health Education
• Disaster Relief & Recovery
• Community Outreach
• Veterans Programs
• Women & Family Services
• Youth Programs
• Senior/ Elder Care Initiatives
• Fundraising
• Sponsorship Development
• Gala & Special Events
• Volunteer Coordination
• Logistics & Supply Management
• Marketing & Communications
• Social Media
• Photography & Videography
• Grant Writing
• Administrative Support
• Finance/ Accounting
• Community Partnerships
• Other

If "Other," please specify

PROFESSIONAL SKILLS / VOLUNTEER EXPERIENCE

List professional licenses, certifications, skills, languages, or volunteer experience that may support HerRelief Jamaica programs.

Professional License / Certification

License Number

State / Country of Licensure

Expiration Date

VOLUNTEER AVAILABILITY

• Local community events
• Medical / dental missions in Jamaica
• Disaster-response missions
• Fundraising events
• Virtual / remote support
• Administrative activities
• Committee participation
• Special projects
• International humanitarian missions
• As needed

Typical Availability

• Weekdays
• Evenings
• Weekends
• Flexible

COMMITTEE INTEREST

• Medical & Health Services
• Dental Services
• Mental Health & Wellness
• Mission Operations & Logistics
• Fundraising & Development
• Sponsorship & Community Partnerships
• Membership & Volunteer Engagement
• Marketing & Communications
• Gala & Special Events
• Finance
• Governance / Board Development
• Other

If "Other," please specify

HOW DID YOU HEAR ABOUT HERRELIEF JAMAICA?

• Current Member
• Community Event
• Medical Mission
• Social Media
• Website
• Church/ Faith Community
• Business / Community Partner
• Friend / Family
• Other

If "Other," please specify

Referring Member's Name

MEMBERSHIP SCREENING QUESTIONNAIRE: After reviewing HerRelief Jamaica's mission and goals, how do you see yourself aligning with the organization? *

Please answer the following questions. Responses help HerRelief Jamaica understand your interests, expectations, and commitment to our mission.

What purpose, passion, or personal motivation is driving your desire to become a member of HerRelief Jamaica? *

If a mission or program requires additional financial support, would you be willing to make a monetary donation and/or participate in fundraising to contribute to its success? *

• Yes
• No
• Maybe/ Depends on the circumstances

Optional Comments

MEMBERSHIP ACKNOWLEDGMENT *

• Support the mission, vision, and values of HerRelief Jamaica.
• Conduct myself professionally and respectfully while representing the organization.
• Protect confidential information obtained through organizational or humanitarian activities.
• Follow all safety, clinical, volunteer, and operational policies applicable to activities in which I participate.
• Pay the applicable membership fee for my selected membership category.
• Notify HerRelief Jamaica of significant changes to my contact or professional information.
• Understand that membership does not automatically authorize me to provide medical, dental, mental health, or other licensed professional services on behalf of HerRelief Jamaica; credentialing and authorization may be required.
• I have read and agree to the Membership Acknowledgement above

By signing this application, I affirm that the information provided is accurate to the best of my knowledge. I understand that submission of an application does not guarantee membership and that membership is subject to HerRelief Jamaica bylaws, policies, standards of conduct, volunteer requirements, and applicable Board-approved procedures.

Applicant's Full Name

Date

MM/DD/YYYY

MEMBERSHIP PAYMENT: Amount Paid – $US

Please complete this section if your membership fee has already been paid.

Amount Paid – $JMD

Payment Method

• Cash
• Check
• Zelle
• Cash App
• Online Payment
• Bank Transfer
• Paypal
• Other

Optional Name requires

If "Other," please specify

Transaction/ Receipt Number

Date Paid

MM/DD/YYYY

Submit