New Member Registration

Title *

First Name *

Last Name *

Membership Type *

Membership Module *

Telephone *

E-Mail *

Street Address *

Country Location *

State or District *

City *

Highest Formal Educational Qualifications *

How did you learn about The VALOR? *

List any 3 skill-Sets you possess *

Give 3 REASONS why you seek to join The VALOR *

How do you intend to achieve each REASON? *

List ALL formal organizations that you have been involved with in the past 5 years (include your Supervisor’s email and number) *

Reference ONE (In the order: First Name/Middle Name/Last Name/Occupation/Address/Email/Phone Number) *

Reference TWO (In the order: First Name/Middle Name/Last Name/Occupation/Address/Email/Phone Number) *

Policy & Terms Agreements (read our FAQ) *

I will email my Professional Profile Picture to info@thevalor.org. *

5 + 1 = ? Please prove that you are human by solving the equation *