BECOME A MEMBER

Download Membership Application OR Fill Out and Submit Below

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Business Phone *

Cell Number *

Email *

Website *

Business Name *

Referred By *

Are you willing to make a commitment to giving referrals? *

Yes

Do you understand that all fees are non-refundable once you are a member? *

Yes

Are you willing to volunteer and participate in events or fundraisers? *

Yes

Will you adhere to the bylaws of SANEWA *

Yes

What do you hope to get out of Senior Action Network? *

After reading the mission statement, how do you feel you can contribute to the group? *

Annual Fee is $60 per business and $40 each additional person that will be attending meetings.
Members are expected to volunteer at minimum two events per year and attend 10 meetings per year.
Applications will be reviewed and approved in the order they are received.

Submit