Join Casa Venezuela New England — Membership Application

Personal Information

First Name *

Middle Name

Last Name *

Preferred Display Name *

Email Address *

Phone Number *

Membership Information

Requested Organizational Role *

You are requesting this role. An administrator confirms or adjusts it during review.

Reason for Joining *

Skills / Areas of Interest

Select all that apply.

Membership Photo *

Upload a clear, recent passport-style or professional headshot.

• Face clearly visible
• Neutral or simple background preferred
• No group photographs, no sunglasses
• JPG, JPEG, PNG or WEBP — maximum 5 MB

Applicant Authorization

Membership Information Authorization. I certify that the information provided in this application is accurate to the best of my knowledge.Photo Authorization. I authorize Casa Venezuela New England to use the submitted photograph for internal membership records and organizational membership credentials.Privacy Acknowledgment. I understand that my contact information will remain private and will not be displayed on the public credential verification page.

Privacy notice: your application, photo and contact details are stored securely and are visible only to authorized Casa Venezuela New England administrators. They are never published, sold or shared with third parties.