Membership Application

We are excited that you are interested in becoming a member of Rainy Day Village Network. After you submit this member application, a membership volunteer will contact you to schedule an introductory meeting. A volunteer will come to your home to talk about what we can offer you and learn about your needs. With the membership team volunteer you will:

Complete the Member Orientation (about 1 hour)
Discuss questions you might have
Read and sign a Member Agreement
Make arrangements to pay your annual membership dues

You will receive an email or phone call from RDVN Membership Team when the Membership is finalized.

First name

Last name

Phone

Cell phone

Date of birth

Marital status

Gender

Number

Street

City

State

Zip Code

Available Membership Options

Trial - one time only: $60.00 for 3 months

Shared: $240.00 for 12 months

Single: $240.00 for 12 months

Household: $375.00 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

Current Health

Mobility issues

Home type

Employment status

How did you hear about us

Additional Comments

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

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