LIV Annual Membership Registration & Invoice
(Fiscal Year 08.01 to 07.31)

Your completed form and payment need to be turned in by October 1 so that you will not have a lapse in membership benefits.

Please make the check out to Leaders in Volunteerism or pay online through LIV’s Pay Pal.
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Agency Registering for Membership *
Type of Membership *
Payment Method *
Mailing Address *
Link to Agency Website *
Individual Contacts
Please share the contact information for all individuals that are covered under this membership. We have provided space to list up to four contacts. If you need to add additional contacts, please reach out to
Name of main contact *
Job Title *
Email *
Phone *
Do you have additional contacts to enter? *
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