Name *

First Name

Last Name

Phone

(###)

###

####

Peace Corps Affiliation *

Interested in Serving

Current Invitee

Current PCV

RPCV

Current PC Staff

Former Peace Corps Staff

Other

Membership Type *

Current Invitee (FREE)

Current PCV (FREE)

Recent RPCV - within 12 months of COS (FREE)

RPCV or Other ($25/year - we'll be in touch re: payment, if you have not paid yet)

Involvement Interests

Check all that apply

Attending social events

Attending educational and cultural events

Participating in local volunteer activities

Giving a presentation about my Peace Corps experience or country of service

Hosting an event

Helping plan/coordinate an event

Assisting with fundraising

Helping with publicity/PR

Providing technical assistance to the board

Serving on our board

Other (we will follow up with you if you check this box)