Membership Application

Membership Application

Thank you for applying to become a member of Arlington Neighborhood Village (ANV).  Our goal is to enable members to continue living in their own homes and communities as they age—safely, independently, and with an enhanced quality of life.  If you are 55 or older and live in Arlington County, you are eligible to become a member of ANV. Visit the membership categories and fees page for the details about membership.

Becoming a member in ANV is a two-step process.  The first step is to complete and submit this application, which you may do either by submitting the online form below or by completing and mailing our print membership application.  The second step is an interview with an ANV representative. When your application is received, we will schedule a time to come to your home to gather additional information and answer any questions you have.  If you and the ANV representative agree that village membership will meet your needs, you will be asked to sign a membership agreement and pay the appropriate fee.

GIFT MEMBERSHIP  If you are submitting this application as a gift membership for someone else,  please provide your name and contact information at the end of the application form.  ANV will contact you prior to setting up the intake interview.

When you are done filling out the application, be sure to click the “Submit” button at the bottom of the screen and wait for the confirmation message to appear.   If it does not appear, please review the form to make sure you have filled in all the required fields, then click on the “Submit” button again.