renewal test page | Loudoun Human Services Network

Organization and Voting Individual Information

Organization Name *

Organization Address *

City *

State *

ZIP / Postal Code *

Country *

Organization Website *

Primary Voting RepresentativeOrganizations can designate one primary voting representative and one secondary voting representative as a back up. .

Full Name *Primary Voting Member

Job Title *Primary Voting Member

Email Address *Primary Voting Member

Confirm Email Address *

Phone *Primary Voting Member

Secondary RepresentativeTo have voting permissions when primary representative is not available.

Full Name *Secondary Voting Member

Job Title *Secondary Voting Member

Email Address *Secondary Voting Member

Confirm Email Address *

Phone *Secondary Voting Member

Membership Dues

Membership dues are based on the size of your Organizational Budget. Please indicate your organization's payment category below:

Select Your Membership *$100/year - Operating budgets LESS than $50,000$200/year - Operating budgets between $50,001 to $999,000$500/year - Operating budgets greater than $1,000,000

Payment Method *Credit CardCheckUnsure at this timePlease let us know if you will be paying by Credit Card or Check. Note: We do not accept Paypal or Venmo at this time.

Payment Options

To pay by credit card:

After completing the Membership Renewal/Application form you will be redirected to the Community Foundation of Loudoun and Northern Fauquier Counties donation Portal.

Please note that the online payment option will note the membership fee as an "LHSN 2026 MEMBERSHIP CONTRIBUTIONS"

IMPORTANT INSTRUCTIONS AT CHECKOUT:

Enter your annual contribution (i.e. LHSN member fee amount) in the field for “One Time Donation Amount”
Click Add to cart
Select the “Organization” button when entering your name (DO NOT SELECT “Individual")
Select Increase Donation to cover the 3% credit card fee (required for all online registrations)
Click Review
Complete payment process. Receipt will be automatically emailed to you.

To pay by check:

Make checks payable to Community Foundation for Loudoun and Northern Fauquier Counties (with “LHSN” in memo line) and mail to:

Community Foundation for Loudoun and Northern Fauquier Counties
PO Box 342
Leesburg, VA 20178

IMPORTANT: include a copy of your 2026 member renewal form

Question: Contact valerie@lhsnva.org

Thank You

Thank you for joining LHSN.

We look forward to working with you.

Don't forget to hit the "Proceed to Payment Options/Submit" below!