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Assistance League - Coppell
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Membership Application
Membership Application
Come, Join Us!
Full Legal Name
*
First
Middle
Last
Preferred name / Nickname
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Email
*
Cell Phone
*
Home Phone
Birthdate, including day, month and year
*
example: 12/15/1964
Emergency Contact
*
Please provide name and contact information.
Spouse
Please provide name and contact information.
Obligations Commitment
*
Member will participate in: Orientation and training, attend monthly meetings, assist one philanthropy, serve on a committee, and support and assist with fundraising projects.
I understand and will commit to the membership opportunities of Assistance League of Coppell. First year dues are $95; subsequent annual dues are $85.
I understand that I am required to provide my own health and accident insurance. Assistance League Coppell is not responsible for any medical or legal expenses that may result from any injury or illness that I may sustain while participating in Assistance League activities. I also agree that I shall maintain adequate personal automobile insurance while using my own vehicle for Assistance League Coppell and shall not hold Assistance League liable for any claims that may result from accidents occurring while I am using my own vehicle for Assistance League business.
Assistance League Coppell has my permission to include my name as a member of and/or donor to Assistance League in its printed materials such as chapter newsletters, event invitations or programs, press releases, etc. Assistance League also has my permission to use any photographs of me taken in connection with Assistance League activities in its printed materials.
I acknowledge that I have read and agree to the Assistance League of Coppell Social Media Policy.
I have read and agree to abide by the Assistance League of Coppell Conflict of Interest Policy.
I acknowledge receipt and understanding of the Assistance League of Coppell WhisteBlower Policy. I understand that I have the right to ask questions about this policy.
I have carefully read the Assistance League of Coppell Protected Persons Behavioral and Reporting Policy. I know the content thereof; and agree to it as my own free act.
What talents / interests are you interested in sharing with Assistance League Coppell?
Check as many as apply.
public relations, marketing or advertising
public speaking
purchasing
building maintenance
leadership or project management
finance, accounting or banking
grant writing
computer skills or computer programming
document creation, editing or graphic design
digital scrapbooking
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