Membership Online Form

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Online Membership Form

To join the Enrichment Center or to renew your membership, please complete this application. Membership is on-going throughout the whole year.

Please make checks payable to the Enrichment Center.

No Refunds Allowed.

Sign-up by January 31^st, 2025 and your name will be entered in a drawing for a $25.00 Gift Certificate to the Bargain Hut!

Today's Date

First Name

Last Name

Address:

City:

State

Zip

Phone Number

Additional Phone Number

Email Address

Receive Center Emails?

Yes

Birthdate

Emergency Contact Name:

Emergency Phone Number

I agree to be photographed, videotaped, and/or recorded while volunteering, and understand that this media may be used in [Community Center Name] Marketing

I accept

Membership Fees

$20.00 - Single

$30.00 - Couple

$50.00 - Fantastic Member

Free Text

Thank you for your support of the Enrichment Center. This special membership helps with the day to day operations of the center and is very much appreciated. Your fantastic membership includes your single or couple membership along with the donation for the operation of the center.

Yes or No

Yes, you can include my name when

No please do not list my name

Free Text

The Enrichment Center is asking for your help with the cost of utilities here at the center. Last year we spent approximately $16,000.00 in utilities to run the building. We are asking for anyone willing to help to give a donation of $25.00 or whatever you can to help with the cost of the utilities. Your donation is optional but very much appreciated.

Because the Enrichment Center is a 501(C)(3) non-profit organization, your contribution is tax deductible.

715-682-2776

Online Membership Form

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