Membership Interest Form

Hello! We welcome the chance to connect with you! By completing this form, you're letting us know you are interested in membership. A board member or volunteer will follow up with you to learn more about you and what interests you about ENN. Please allow time for us to respond. Meanwhile, consider attending one of our events to help us get acquainted.

Please note: Under "Local Village," click on "Please choose" to select your neighborhood from the list.

Your Information

First name

Last name

Most Village correspondence is sent via email:

I use email (this is a good way to notify me) I do not use email (if you email me information, I will likely not see it)

Phone

Cell phone

Date of birth

Local village

Address

Number

Street

City

State

Zip Code

Available Membership Options

Monthly Payment Options- Individual Builder/Social: $10.00 per month for 12 months Social - Individual: $120.00 for 12 months

Additional Information

How did you hear about us

What made you interested in becoming a member?

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 contacting us — it’s a pleasure to connect! Our team is committed to providing friendly, professional assistance, and we’ll be reviewing your message right away. You’ll hear back from us soon.