Volunteer Mid-South

Home

About Us

VOLUNTEER! Current Projects

Programs & Services

Trainings and Orientations

For Agencies

For Companies

Support Us


	Connecting: People. Resources. Organizations.

Welcome to the Volunteer Mid-South Member Registration.

Use the form below to register as a volunteer for Volunteer Mid-South projects, courses, and special events.

* denotes a required field

Member Registration Form

First Name *
Last Name *
Date of Birth *
	mm/dd/yyyy
We require date of birth for verification of eligibility with affiliate projects/activities and for demographic reporting for funders.

Mailing Address *
Address Line 1 *
Address Line 2
City *
State *
Zip code *
Region

Main Phone Number *		Type*
Other Phone Number		Type

Place of Employment

Your login information will be:

Email Type *

E-mail Address *

Re-Enter E-mail Address*

Password *

Re-Enter Password *

Sign me in Automatically

Click here if you have a disability.

Availability

	Weekdays (Monday - Friday)
	Weeknights (Monday - Friday)
	Weekends (Saturday - Sunday)
	Weekdays & Weekends
	Weeknights & Weekends
	All / Anytime
	I am available to work on short notice for important volunteer needs

Terms and Conditions

I understand that as a volunteer with Volunteer Mid-South. (later referred to as VM) I will be volunteering my services to various social service agencies. I understand the nature of the volunteer activities that are typically performed by VM volunteers. I also understand that as a VM volunteer I may be asked to perform activities that involve physical activity, contact with unidentified and unfamiliar persons, travel to and from various unspecified locations, and other potential risks of injury. In connection with my voluntary involvement in activities undertaken for and with the participation and support of VM, a non-profit charitable corporation, I hereby agree, for myself, my heirs, assigns, executors and administrators to release and discharge VM, its officers and directors, employees, agents, and volunteers from all liability and responsibility pertaining to any claims, demands, and actions resulting from injuries, physical or mental, sustained to my person and/or property as a result of my involvement in such activities whether or not resulting from negligence. I agree to release and hold VM, its officers and directors, employees, agents, and volunteers harmless from any cause or action, claim, or suit arising therefrom. I hereby attest that my attendance and involvement in such activities is voluntary, that I am participating at my own risk, and that I have read the foregoing terms and conditions of this release. 

I hereby confirm, represent, and warrant that I have never been convicted of or charged with, in this state or any other, a violent crime, child abuse or neglect, child pornography, child abduction, kidnapping, rape or any sexual offense, nor have I been ordered by a court, in this state or any other, to receive psychiatric or psychological treatment in connection therewith. I confirm that I have never been terminated, suspended, placed on probation, reprimanded or otherwise penalized by an employer for child abuse and/or maltreatment, or violent acts of any kind in this state or elsewhere. I attest that I have read and understood the following terms and statements of this screening summary and that the statements and confirmations I have made herein are true, correct and complete.

I agree I disagree


	AN AFFILIATE OF