Form
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Date of Birth
Membership Information: Are you registering as a:
Advocate
Member
Volunteer
Participant
How did you hear about F.I.R.E Lady Inc?
Facebook
Event
Referral
Other
Are you available to attend our monthly virtual meetings (every 4th Sunday)?
Yes
No
Are you able to attend at least one of 3 mandatory events per year (October, November, and December)?
Yes
No
Do you agree to complete advocacy training before participating in official events?
Yes
No
What skills, talents, or areas of expertise would you like to share? (Check all that apply)
Public Speaking
Fund Raising
Event Planning
Counseling/outreach
Administration
Other
Why would you like to join F.I.R.E Lady Inc?
Please list any prior experience with community service, advocacy, or nonprofit work.
Signature
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