MCSV Membership Renewal Form
To renew your membership please complete the form below.   

General Information

Last Name:
First Name:
Middle Initial:
Address1:
Address2:
City/State/Zip:
Daytime Phone:
Evening Phone:
Cell Phone:
E-mail Address:
Sex:         Male:          Female: 
Age Group: 21-30            31-40           41-50 
51-60            61 +  

Favorite Non-Profit  Organization/Charity:

Member Directory Election

I elect to have my phone number and/or e-mail address included in the MCSV Member Directory.  The MCSV Member Directory will only be distributed to the members who include their information in the directory.  Membership is not dependent upon being published in the MCSV directory.  

Please check the appropriate box(es) below:

  Please include my phone number in the MCSV Member Directory.
  Please include my e-mail address in the MCSV Member Directory.
  Do not include my phone number or e-mail address in the MCSV Member Directory.

Volunteer Agreement

I hereby release Mercer County Single Volunteers (herein after "MCSV") and its administrators, project leaders, organizers, volunteers, and any other persons acting on behalf of MCSV from any claims arising from my volunteer work with MCSV or participation in any social activity with MCSV.

I also agree that MCSV holds no responsibility for the outcome of any relationship that may or may not occur between myself and another person that I might meet through MCSV.  In accepting a date or otherwise agreeing to meet with another member either within a MCSV-sponsored volunteer opportunity or social event, or on my own time, I take sole responsibility for any actions that might occur during that date or meeting, and agree to hold MCSV free from any liability.

I agree not to initiate any claim against MCSV resulting from either volunteer, social, or dating activities.

I agree to participate in three volunteer opportunities during the calendar year.

By agreeing to attend any Single Volunteers sponsored event, social, or meeting I acknowledge that I have read and do understand the terms contained within the Mercer County Single Volunteers Agreement.

I Agree    
I Disagee    

Dated:                           Month:       Day:       Year: 

Notes: 
Required fields are in bold.
No fee for membership renewal.