Olympia Area Village Membership Form

Some of the questions on this form may surprise you, but the answers (used anonymously of course) are essential when OAV applies for grants. The granters often want to be able to show that their money will be used for the benefit of diverse populations. However, know that the answers to the questions about gender and sexual orientation are optional.
Once you have completed this online form, be sure to confirm consent and click on the red SEND button.
Be sure to complete the form in one sitting, or you will need to start over.
The next step in becoming a member is to go to the top right corner of any page on this website and click on the red DONATE NOW button. That will take you to a page where you will scroll down to the DONATION AMOUNT box and write in 200 (the dollar sign will auto-fill). Skip the monthly donation box and then fill in your name and address, skip the fundraising box and scroll down to COMMENTS. In this box type ‘for yearly membership’. Finally scroll to PAYMENT METHOD—put in your credit number to pay by credit or debit card. If you wish to pay with something other than a credit card, please indicate this and contact us at our email, [email protected].
Once you have completed these two steps, the Village will run your background check and mail to you a membership agreement for your signature.

First name

Last name

Phone

Cell phone

Date of birth

Marital status

Gender

Sexual orientation

Ethnicity

Number

Street

City

State

Zip Code

Individual: $200.00 for 12 months

First emergency contact name

First emergency contact cell phone

First emergency contact phone

First emergency contact email

First emergency contact address

First emergency contact relationship

Second emergency contact name

Second emergency contact cell phone

Second emergency contact phone

Second emergency contact email

Second emergency contact address

Second emergency contact relationship

Your interests what do you love doing

Special expertise

How did you hear about us

What interested becoming member

I confirm that I have read, consent and agree to Revolutionaging’s (Helpful Village’s) TERMS OF USE and PRIVACY POLICY

Thank you for your interest and we will be in touch with you very soon!