Member Information

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Note:

⚠️ Don't use autofill as it might change other fields on this form. If your browser inadvertently uses autofill, be sure to verify that name and email fields are correct before submitting.

Member Name

Enter first name at it appears on credit cards, use Nickname for first name you prefer to be called.



Enter first name you would prefer to be called.

Enter birthdate in format mm/dd/yyyy



 Member Address








 Member Email



 Member Phone




Circle Fund Cumulative Statistics


Spouse/Partner Name


Emergency Contact Information




Alternate Emergency Contact Information





Note: This reflects the membership classification that is currently listed in Chapter Hub. If you need to change it, please follow your chapter guidelines.

Note: Enter the total volunteer hours for the fiscal year that is ending.


CONFLICT OF INTEREST POLICY
I have read and agree to abide by the conflict of interest policy as presented on the chapter website.


ETHICS
I have read and agree to abide by the Ethics policy presented on the chapter website.
HARRASSMENT, DISCRIMINATION AND BULLYING
I have read and agree to abide by the Harassment, Discrimination and Bullying policy presented on the chapter website.
HOLD HARMLESS/RELEASE OF LIABILITY
I have read and agree to abide by the Hold Harmless/Release of Liability policy presented on the chapter website.
INSURANCE
I have read and agree to abide by the Insurance policy presented on the chapter website.
PHOTO AND NAME RELEASE
I have read and agree to abide by the Photo and Name Release policy presented on the chapter website.
PROTECTED PERSON BEHAVIOR AND REPORTING
I have read and agree to abide by the Protected Persons policy presented on the chapter website.
SELF- DEALING 
I have read and agree to abide by the Thrift Shop Self Dealing Policy as presented on the chapter website.
SOCIAL MEDIA & COMMUNICATIONS 
I have read and agree to abide by the Social Media and Communications Policy as presented on the chapter website.
WHISTLEBLOWER PROTECTION
I have read and agree to abide by the Whistleblower Protection Policy as presented on the chapter website.
AGREE TO BACKGROUND CHECK
I agree to have a background check as a requirement of membership.
AGREE TO CHAPTER OBLIGATIONS
I have read and understand chapter obligations as presented on the chapter website.
Skills
Select skills in the categories listed below indicating level of proficiency.

If there is a skill that you no longer want included, change the status to Inactive or if there is another skill you would like to replace it with, change the skill and update the Proficiency.

If you are entering skills for a category and inadvertently add another skill, but don't have another skill you want to list, please click the "Remove" link. Clicking "Remove" will have no effect on skills that were present from the last time you updated the form.

Building Maintenance Skills 

             
             Skill                                                                 Proficiency                             Status            
If you clicked Add another Building Maintenance Skill and there is none to select, please click Remove and OK before submitting the form.

Business Skills

             
           Skill                                                                 Proficiency                             Status
If you clicked Add another Business Skill and there is none to select, please click Remove and OK before submitting the form.

Communication Skills

           
            Skill                                                                 Proficiency                             Status
If you clicked Add another Communications Skill and there is none to select, please click Remove and OK before submitting the form.

Computer Skills

               
          Skill                                                                      Proficiency                          Status
If you clicked Add another Computer Skill and there is none to select, please click Remove and OK before submitting the form.

Creative Arts Skills

                
          Skill                                                                      Proficiency                          Status
If you clicked Add another Creative Arts Skill and there is none to select, please click Remove and OK before submitting the form.

Marketing Skills

                      
          Skill                                                                      Proficiency                          Status
If you clicked Add another Marketing Skill and there is none to select, please click Remove and OK before submitting the form.

Resource Development Skills

                          
          Skill                                                                      Proficiency                         Status
If you clicked Add another Resource Development Skill and there is none to select, please click Remove and OK before submitting the form.

Retail Skills

                
         Skill                                                                      Proficiency                         Status
If you clicked Add another Retail Skill and there is none to select, please click Remove and OK before submitting the form.
No Member Record
Either you are not logged into the national website or you are not logged in with the email that is in Chapter Hub. Check your email, login, and try again.

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National Board, Chapter Board and National Committee Experience
The positions listed below reflect what is currently in Chapter Hub. If there is missing or incorrect information, please enter in the field below.  Be specific as to position, start date and end date. This will be reviewed and updated. It will not happen automatically. If you don't know specific date, enter the information in "Summary of Chapter and National Experience".
Chapter where you held position. National Assistance League if it was a National Leadership position.



Can be used if you do not know dates of prior positions.

Enter other nonprofit experience and the capacity in which you served.