Volunteer Account Registration

USERNAME (required)

Username must be at least 6 characters.
Can not contain spaces.

PASSWORD (required)
CONFIRM PASSWORD (required)

Password must be at least 8 characters.
Must contain a special character.

LEGAL FIRST NAME (required)
MIDDLE NAME
LEGAL LAST NAME (required)
PREFERRED FIRST NAME (if different)
E-MAIL (required)
CONFIRM E-MAIL (required)
PRIMARY MOBILE PHONE # (required)
SECONDARY PHONE #
SECONDARY PHONE TYPE
COUNTY (required)
How did you hear about SERV-KS?*

Are you willing to participate in a federal response?

Please check the box if you are an active member of these response organizations:





By submitting, you agree to receive text and email messages from SERV-KS. Message frequency may vary. Message and data rates may apply.