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OSC MEMBERSHIP FORM
No senior will be denied access to membership to inability to pay. Scholarships are available for those who need them. Please contact
360-376-7929 or
admin@orcasseniors.org
for more information.
Membership Level Options
*
$
500
-
GOLD PREMIER - couple
$
300
-
GOLD PREMIER - single
$
200
-
PRIME - couple
$
125
-
PRIME - single
$
50
-
STANDARD - couple
$
30
-
STANDARD - single
I/We wish to make an additional contribution to support OSC (Please select only one):
$
500
$
250
$
100
$
50
$
25
$
Contact Information
1st Member NAME
*
First Name
Last Name
2nd Member NAME
*
First Name
Last Name
1st Member EMAIL
2nd Member EMAIL
1st Member PHONE
2nd Member PHONE
YES! I am interested in volunteering for OSC.
YES! I am interested in volunteering for OSC.
ADDRESS
*
Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
How would you like to receive our newsletter?
*
select one
Email
Mail
Both Email + Mail
I do not want to receive a newsletter.
Referred by:
First Name
Last Name