Register - Benevolence Fund Portal

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Personal Information

First Name *

Last Name *

Email Address *

Phone Number *

Date of Birth

Home Address

Street Address

City

State/Province

Postal Code

Country

Emergency Contact

Emergency Contact Full Name *

Emergency Contact Phone *

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Spouse/Partner Information *

Do you have a spouse? *

Yes, I have a spouse None

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Children Information *

Do you have children? *

Yes, I have children None

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Parents Information *

Do you have living parents/guardians? *

Yes, I have living parents/guardians None

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Siblings Information *

Do you have siblings? *

Yes, I have siblings None

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Beneficiaries Information *

Do you have beneficiaries? *

Yes, I have beneficiaries None

💡 Note: Choosing "None" will automatically list you as 100% beneficiary with your own name and phone contact.

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Kansas/Missouri Residency & Attestations

When did you move to Kansas/Missouri? *

Less than 4 years ago More than 5 years ago

Are you a Kansas/Missouri resident or a student? *

I'm an adult resident of the Kansas/Missouri region I'm a student who has lived in Kansas/Missouri for less than 4 years I'm a student who has lived in Kansas/Missouri for more than 4 years

How did you get to know about MNK? *

Attestation

I am aware that if I list step siblings, in-laws or children that are not biologically mine or not legally adopted by me, I and my endorser will be deemed to have engaged in fraud and my MNK membership and my endorsers MNK membership will be subject to termination.

I have read and understood the My Neighbor’s Keeper Benevolence Fund Policies and that the information I have provided in this document is accurate.

I also authorize the verification of the biological or legal adoption relationship information that I have provided in this form as to its accuracy in accordance with My Neighbor’s Keeper Benevolence Fund Policies.

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Password Setup

Password *

Password must be at least 10 characters with uppercase, lowercase, and special character

Confirm Password *

Member Registration

Home Address

Emergency Contact

Attestation