Palmer Home Partner Application

Palmer Home Partner Membership Commitment Form

Thank you for your interest in becoming a member of the Palmer Home Partner Northwest Mississippi Chapter. As a member, you will play a vital role in supporting Palmer Home for Children through your time, talent, and treasure. This commitment form outlines the expectations for membership and engagement.

Your Information
Name*
First Last
Email*
Phone*
Preferred Contact Method
- Email
- Phone
- Either
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Membership Level
Type*
Corporate Contact
For corporate memberships, please provide company name and primary contact.
Which chapter are you interested in joining?*

Volunteer Interests & Skills
Volunteer Interests & Skills*
Please check all areas in which you or your team would be interested in volunteering or contributing:
- Select All
- Event Planning
- Marketing and Communications
- Fundraising
- Administrative Support
- Community Outreach
- Mentorship (Background check and training required)

Commitment Expectations
General Member Expectation*
I will advocate for Palmer Home with integrity, respect, and professionalism in my personal and professional network.
Time Commitment*
I will dedicate at least 15 hours annually to Palmer Home-related volunteer activities, events, or chapter meetings. These hours can be completed through various activities, including volunteering at events, assisting with fundraising efforts, or helping with special projects.
Talent Commitment*
I will contribute my skills, connections and/or expertise to enhance chapter operations and Palmer Home’s mission. This may include (but is not limited to) event planning, marketing, social media, community outreach, networking or recruitment.
Treasure Commitment*
I will raise or contribute at least $130 annually, in honor of the mission's 130 years of service, through one or more of the following: Personal donations, fundraising events, and corporate sponsorships or matching gift programs. Contributions can be in the form of monetary donations, in-kind gifts, or corporate support.
Chapter Engagement Commitment*
As a Palmer Home Partner, I am encouraged to: (1) Attend at least one meeting, volunteer activity or event per quarter to ensure ongoing involvement and engagement. (2) Participate in one community outreach or awareness-building event each quarter—social media campaigns, informational meetings, etc. (3) Support at least one fundraising effort or campaign annually.
Consent*
By entering my initials below, I confirm my commitment to the membership guidelines of the Palmer Home Partner Chapter and agree to fulfill my obligations to the best of my ability. I understand that my engagement and contributions are vital to the success of Palmer Home’s mission and the support of children and families in need.
Date*
Date Format: MM slash DD slash YYYY

Payment
To donate your $130 Membership fee, go to www.PalmerHome.org/donate and enter “Palmer Partner Middle Tennessee" or “Palmer Partner Northwest Mississippi” in the notes.
Questions or Concerns
For questions or additional information, please contact April Douglas at (818) 205-7777 or ADouglas@palmerhome.org.
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Palmer Home Partner Membership Commitment Form

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Volunteer Interests & Skills

Commitment Expectations

Payment

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Impact Report

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Palmer Home Partner Application

Palmer Home Partner Membership Commitment Form

Step 1 of 5

Your Information

Membership Level

Volunteer Interests & Skills

Commitment Expectations

Payment

Questions or Concerns

Events

Impact Report

Newsletter

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