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PRINTABLE VERSION
MEMBERSHIP REGISTRATION
Volunteer Perth-Huron ‐ Membership Application Form.
Select the level of membership
Non-Profit Membership - $50.00
Profit Membership - $100.00
Affiliate Membership - $0.00
*
Payment Method
I'd like to pay via Invoice
I'd like to pay via PayPal
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Organization Name
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Logo
(JPG, PNG, GIF; 4MB max)
*
Program Name (if applicable):
Banner Image
(JPG, PNG, GIF; 4MB max)
Address:
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Address (2nd Line)
City/Town
*
Province:
Ontario
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Prince Edward Island
Quebec
Saskatchewan
Yukon
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Postal Code
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Main Phone:
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Fax:
Other Phone:
Website
Social Media Links (if applicable):
Year Established? (if applicable):
If you are a registered non ‐ profit or charity, please provide your number below:
If you are an organization, please indicate which community your organization serves (select all that apply):
[ - ]
All of Huron
All of Perth
Ashfield–Colborne–Wawanosh
Bluewater
Central Huron
Clinton
East Perth
Goderich
Howick
Huron East
Morris-Turnberry
North Huron
North Perth
South Huron
South Perth
St. Marys
Stratford
West Perth
Select All
Name of Volunteer Manager/Coordinator:
*
Phone:
*
E-mail:
*
Does the Volunteer Manager/Coordinator wish to receive communications?
Yes
No
Organization/Chapter Head:
Phone:
E-mail:
Does the Organization/Chapter Head wish to receive communications?
Yes
No
Board Chair (if applicable):
Phone:
Email:
Does the Board Chair wish to receive communications?
Yes
No
If you are an organization, please provide a brief description about your organization, the services/programs provided, and your organization’s impact on the community: (300 words maximum)
*
# of Staff (if applicable).
This field only accepts numbers.
# of Volunteers you currently have (if applicable).
This field only accepts numbers
How did you hear about us?
choose one
From another organization
From Step Up Youth Volunteer Ambassadors
At an event
During a group presentation
During an educational program
Newspaper / magazine
During an internet search
Through Social Media
Radio / TV
eNewsletter
From another person
Other:
Members receive a year’s membership and can post as many positions as needed throughout the year
