Membership Application

Regular membership $25 per year

Arc staff members $15 per year

Self-advocates $10 per year

What does Arc membership include?

– Automatic membership in both The Arc of Virginia and The Arc of the United States.

– Invitation to two “open house” events to learn how we impact the disability community and change lives.

Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone
Email*
Please send me information about volunteer opportunities
- Yes
- No
Do you have a person with developmental disabilities in your family?
- Yes
- No
What is his/her name?
First Last
Age
Please check which of our services interest you or your family member?
- Child Care
- Respite Care
- Workshops
- Recreation Programs
- Residential Programs
- Vocational Programs
Membership Type*
Total
$0.00
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.

Your membership dues are tax deductible.

If you wish to join the Arc, please fill out the Membership Application above. Once you have filled it out, please print it off then mail it, along with your dues, to:

The Arc of Greater Prince William
13505 Hillendale Drive
Woodbridge, VA 22193

*Checks should be made payable to ARC-GPW