ElderFire: Membership Application Form

Become a Charter Member of ElderFire

It only takes a couple of minutes to take the first step toward engaging in a new experience of life. Become part of a community of ideas, resources, connection, support and benefits. Complete this form to join ElderFire today.

ElderFire respects your privacy. We won't exchange or share your information with other organizations without your express permission. We won't send you email unless you tell us it's ok, telemarket to you, or give your information to those who do.

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How would you prefer to be contacted? Indicate your choice and provide your contact information in the form below.
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Help us plan future activities and workshops.

Your ideas are important. Won't you take a moment to indicate your areas of interest, your passions and your concerns? Thank you.

What are you passionate about?

Tell us what matters to you, what fills you with a sense of accomplishment and what you'd like to change. For example: Contemporary community issues, creative expression, societal contributions, personal transformation, global mind change or anything that moves you to action.

How can ElderFire help with the challenges you face?

What are your needs and concerns, now and in the future? Would you like help in meeting specific challenges? For example: Connecting with like-minded people, intellectual stimulation and engagement, physical or emotional security and safety, access to activities and cultural exposure or finding living opportunities.

Would practical aid or information from ElderFire make your life easier in concrete ways? Tell us what you need. For example: Finding trustworthy health information, providers for life's transitional needs, home and auto repair, appropriate housing, transportation, technical assistance or travel and leisure services.

What talents and expertise would you like to share with ElderFire Communities?

You bring a lifetime of experience others can draw upon. What are your skills, talents and knowledge areas you'd like to contribute? For example: Teaching and mentoring, facilitating group discussions, researching and exploring ideas or issues, public advocacy, public speaking, organizing groups or specific areas of expertise such as writing, computers, photography, sports or anything at which you excel.

Become a Charter Member

Submit this application now and pay your membership fee securely and conveniently through PayPal. Or submit your application now and mail your membership fee to:

ElderFire Communities
428 Bryant Circle #226
Ojai, CA 93023