User Registration Request

This registration is for employees and independent contractors of Multicultural Community Services only. If you are not an employee or independent contractor please do not register.

Please Note: It may take up to 72 hours for your registration to be reviewed and processed. Once your account is created you will receive 2 emails containing your login information. These emails will be sent to the email address you provided.
Today's Date:*
MM slash DD slash YYYY
Name:*
First Last
Position:*
Supervisor Name:*
First Last
Multicultural Community Services will never send you an email asking you to either register your account or verify any personnel information including your username and password. Please remember to keep your username and password confidential.
Email:*
Employee / Independent Contractor Agreement*
- I agree that I am currently an employee or independent contractor with Multicultural Community Services
Signature*
Please enter the code shown below:

Multicultural Services of Pioneer Valley, Inc