Name *

First Name

Last Name

Phone

(###)

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I plan to volunteer with

Select one or several non-profit partners you plan to volunteer with! Co-op staff will provide you with more information on each organization as needed.

After the Harvest

Ecumenical Campus Ministries (ECM)

Friends of the Kaw

Growing Food Growing Health

The Hub Argentine

Just Food

KC Shepherd's Center

Lawrence Barn Dance Association

Lawrence Meals on Wheels

Midland Care Meals on Wheels

PermaCommons Community Garden

Positive Bright Start

Sunrise Project

Volunteer Memorandum of Understanding *

As a volunteer participant in the MercWorks Co+op Volunteer Program, I have read, understand and agree to the following: My volunteer work must be performed for an approved MercWorks non-profit partner in order to receive any of the benefits described below. I will conduct myself in a professional, respectful and honorable manner that reflects positively on The Merc Co+op and the non-profit partner. I will be prompt when expected to volunteer and provide adequate notice if/when I am unable to meet my volunteer commitments. I will complete all mandatory orientation and training required by The Merc Co+op and the MercWorks non-profit partner. I understand I will earn one single-use coupon the month after I complete my volunteer hours: for at least three hours that I volunteer each month, I will receive a 10% off coupon in the mail; for anything over 3 hours, I will receive a 15% off coupon in the mail. These coupons expire after one (1) month. I understand that the single-use coupon is the maximum allowable discount for a single purchase. This volunteer coupon cannot be combined with any other discount in the same transaction including Owner discounts, other volunteer coupons or senior discounts. I understand that these single-use volunteer coupons cannot be “banked” in a way that results in me having more than one unused coupon at any one time. I understand that it is my responsibility to coordinate with the non-profit partner to ensure that my volunteer hours are tracked accurately and/or to have the MercWorks Volunteer Form signed by an approved staff member of the non-profit partner. I understand I must turn in my hours to the co-op before the 10th of the month following the month worked. (eg. January hours must be turned in by February 10th.) I understand that I must have an active Ownership at The Merc Co+op to remain on the MercWorks team and to receive discount coupons. I understand my ownership share belongs to the individual that signs the application, and only other household members may use the ownership for all purposes including MercWorks activities and discounts. A household is defined as the owner and the owner’s spouse/partner and children and/or other dependent household members living at the owner’s address. I understand I am not eligible to receive a MercWorks discount if I am a paid employee of the non-profit partner I submit volunteer hours for. I give my consent to allow The Merc Co+op the authority to publish my name, photograph and volunteer story for promotional purposes such as the Co+nnections newsletter, enews, press releases, articles and social media. I understand that nothing in this Memorandum of Understanding should be construed to create a partnership, joint venture, or employer-employee relationship between myself and The Merc Co+op. I am not an agent of The Merc Co+op and am not authorized to make any representation, contract, or commitment on behalf of The Merc Co+op. As a volunteer, I will not be entitled to any of the benefits or compensation which The Merc Co+op may make available to its employees. I understand that failure to comply with these requirements may result in my removal from the MercWorks program. The Merc Co+op does not discriminate on the basis of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex, age, or sexual orientation, or any intent to make such a limitation, specification, or discrimination unrelated to ability to perform the work required.

I have read, understand, and agree to the Volunteer Memorandum of Understanding. I understand that access to my discount depends on compliance with the requirements set out by The Merc Co+op and its non-profit partners. I am signing on behalf of my entire household.