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Register as a Project Leader

 

Please fill out the form below to become a project leader. After registration and approval, you can begin posting Volunteer Week projects. Volunteer companies can then sign up for up for your Volunteer Week projects.

* = Required fields
 

Project Leader Information:

Agency Name*:
Organization Tax ID*:
  TaxID is required to verify charitable status
 
Please provide a brief description of your agency and the services you provide:
 
 
Project Leader First Name*:
Last Name*:
Title:
Email Address*:
Phone*:
Fax:
Address*:
City*:
State*:
Zip*:
Area*:
Region*:
  
Alternate Contact First Name:
Alternate Contact Last Name:
Alternate's Email:
  
Company Chief Executive:
  

Password Information:
Enter Password*:
Re-Enter Password*:

Photo Release:

I/We hereby irrevocably grant to the Insurance Industry Charitable Foundation (IICF) and its licensees, successors and assigns, the right, license and privilege to use my/our name, likeness, voice, performance, personal characteristics photograph and biography, in whole or in part, throughout the universe, in all formats and media now known or hereafter devised, in such manner as IICF shall deem appropriate for the purpose of promoting, advertising and publicizing IICF and its charitable activities.

I/WE hereby release and agree to indemnify IICF and its licensees, affiliates, successors and assigns, from and against any and all liability, costs and expenses, including reasonable attorneys’ fees, arising out of the exercise of the rights granted hereby. In no event shall I/we have any right to seek or obtain injunctive or other equitable relief with respect to IICF. The parties submit any disputes arising out of or related to this Publicity Consent and Release cannot be terminated, rescinded or amended hereafter except by a written agreement, signed by all parties. This Publicity Consent and Release shall be exclusively governed by and construed in accordance with the laws of the State of California, without regard to conflicts of laws principles.

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