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	Be the change. Volunteer

Welcome to the MassVolunteers Member Registration.

Use the form below to register as a volunteer for MassVolunteers 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 *

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Gender

Race

Education Level

Marital Status

How did you hear about us?

	Internet			Word of Mouth
	Company/School			Special Event/Volunteer Fair
	Newspaper			Radio
	Web Search			Hands On Network Affiliate

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

In connection with my voluntary involvement in activities undertaken for, and with the participation and support of HandsOn Mass, I hereby agree, for myself, my heirs, assigns, executors, and administrators to release and discharge HandsOn Mass, its officers and directors, employees, agents, and volunteers from all claims, demands, and actions for injuries sustained to my person and/or property as a result of my involvement in such activities, whether or not resulting from negligence, and I agree to release and hold HandsOn Mass, its officers and directors, employees, agents and volunteers harmless from any cause of action, claim, or suit arising there from.  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 a violent crime, child abuse or neglect, child pornography, child abduction, kidnapping, rape or any sexual offense, nor have I ever been ordered by a court to receive psychiatric or psychological treatment in connection therewith.

I hereby grant HandsOn Mass the irrevocable right to use forever any film, video tape, audio tape, photographs, slides, or combination thereof, for inclusion in any promotional or advertising purposes, and I agree to appear without pay.

I agree I disagree


	AN AFFILIATE OF