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About Us
- Services
- Board/Volunteers
News & Events
- News
- Events
- Newsletter
- Gallery
Donate
Sponsors
- Current Sponsors
Volunteer
- Testimonials
- Resident Testimonials & Consent Form
Resources
- In the Literature
Contact Us

Resident Testimonials & Consent Form

Please provide feedback to share anything about your Village experience or how it has affected your life.

purposes and photo/video

Name

First

Last

Email *

Service(s) Provided *

Transportation Assistance
Friendly Visits and Calls
Technical Assistance
Other

Testimonial Statement (Please provide feedback to share anything about your Village experience or how it has affected your life.) *

May we post your testimonial (or a portion of it) for Public Relations purposes (Publications online, print distribution, and internet media platforms)? *

Yes
No

May we include your name in your testimonial? *

Yes
No (I prefer to remain Anonymous)

May we use your photo/video for Public Relations purposes (Publications online, print distribution, and internet media platforms)? *

Yes
No

Consent to Publish Testimonial *

I hereby grant Mill Creek Village the right to use my testimonial as described above.

See below for a Printable PDF Form that you can download for printing instead of using the online form:

Download Printable PDF Form

Recent News

Mill Creek Village Thanks Our Volunteers at Appreciation Luncheon at Sasuns Cafe
Mill Creek Towne Neighbors Enjoy MCV 8th Annual Wine & Cheese Party
Mill Creek Towne Neighbors Enjoy Food and Festivities at MCV’s 12th Annual Community Picnic!

Donation Amount (USD)

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