MyImpactPage - MARS Wildlife Rescue Centre

Thank you for your interest in becoming a MARS member.

Please complete this registration form to create your MARS member profile. After submitting the form, you will be directed to complete your membership payment through Square. Your membership will be active once your registration and payment have been matched and approved.

Please use the same name and email address for this form and your Square payment whenever possible.

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Don't have an account on MyImpactPage.com? Just fill in your details to get started!

Account

Username

Required

Username must not start with space

Username must not end with space

Username must not have two or more spaces in a row

Password

Required

	Password needs to have at least 12 characters.
	Password needs to have at least one upper case character.
	Password needs to have at least one lower case character.
	Password needs to have at least one number.
	Password cannot be on a list of commonly-used passwords.

Confirm Password

Required

	Password needs to have at least 12 characters.
	Password needs to have at least one upper case character.
	Password needs to have at least one lower case character.
	Password needs to have at least one number.
	Password cannot be on a list of commonly-used passwords.

Name Fields

Salutation
Legal First Name
First NameRequired
Middle Name
Last NameRequired
Suffix
Pronouns

Address

Address line 1Required
Address line 2
CityRequired
Country Required
State / Province Required
Zip / Postal CodeRequired

Email Addresses

Email Address Required
Secondary Email Address

Phone Numbers

Required Please enter at least one phone number

Home Phone
Work Phone
Work Extension
Cell Phone
Phone Preference

Online Presence

X Username

Linkedin Profile URL
Instagram Username

Misc Fields

Region

Please answer the following questions so we can set up your MARS member profile.

You will also be asked to choose which types of MARS email communications you would like to receive.

Email Communications

Wants MARS Raffle/Fundraising Emails

Required

Wants MARS Newsletters

Required

Wants MARS General Emails

Required

Membership Details

Membership Category

Required

New or Renewing Member

Required

Name Used for Square Payment

Required

Email Used for Square Payment

Required

Family Membership Details

Spouse / Partner First Name

Spouse / Partner Last Name

Child Name(s)

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