Become a Member of The Arc

Contact us to find a local chapter, or you can use this form to join The Arc-Wisconsin.

MEMBERSHIP APPLICATION FORM


Name(s) ____________________________
Title(s): Ms. Mrs. Mr. Mr. & Mrs.
Address _____________________________
City _________________________________
State __________________Zip ___________
Phone (H) ____________________________
Phone (W) ____________________________
Legislative District ______________________

Your relationship to a person with a disability:
Parent Grandparent Friend
Sibling Professional Other
_______$30.00 Membership Fee Enclosed

or

I am a person with a disability:
_______$15.00 Self-Advocate Reduced Fee

Please submit this form with membership fee to:

The Arc-Wisconsin Disability Association
2800 Royal Ave., Suite 202
Madison, WI 53713