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LUC New Member Application Pagewebadmin2025-07-08T17:08:57-04:00

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Fill out the form to become a

Lift Up Carolinas Member!

PLEASE NOTE, ALL FIELDS ARE REQUIRED

Contact Information

First Name *

Last Name *

Preferred Name *

Email Address *

Mobile Phone Number *

Home Phone Number

Address *

City *

State *

Zip *

Birthday Month (number) *

Birthday Day *

Birthday Year *

Emergency Contact Information

Contact Name *

Contact Phone Number *

Contact Relationship *

Experience

Volunteer Experience (you must enter something here even if N/A) *

Work Experience (you must enter something here even if N/A) *

I have experience & can help in these areas (you must select at least 1): *

Accounting

Education

Grants

IT

Marketing/Communication

Online Sales

Operations

Public Safety

Retail

Social Media/Photography

Strategic Planning

Requirements

Criminal Background & Sex Offender Registry Screenings *

I consent to criminal background and sex offender registry checks.

Photo Release *

I agree to give Lift Up Carolinas, and other entities covering chapter activities, permission to publish my name, likeness, or image to print, electronic or visual format and to waive any rights of compensation or copyright ownership related to them.

Name Release *

I agree to give Lift Up Carolinas permission to include my name as a member and/or donor to Lift Up Carolinas in its printed materials such as newsletters, event invitations or programs, press releases, etc.

Liability Waiver *

I understand that Lift Up Carolinas is a member volunteer organization in North Carolina. I do hereby release, forever discharge, and covenant to hold harmless Lift Up Carolinas, its members, employees, representatives, and Board members from any and all causes of action, lawsuits, claims, demands, liability, foreseen and unforeseen costs, medical expenses, or any compensation for personal injuries, property damage, or any type of damage whatsoever which I may have on account of or in any way growing out of my participation as a member volunteer in any and all programs or activities of or in any way growing out of an association with Lift Up Carolinas.

CLICK ON THE ORANGE BUTTON TO SUBMIT YOUR APPLICATION

THEN ON THE RED BUTTON TO GO TO PAYMENT OPTIONS.

Click here to go to payment options