Online Membership Application

Membership Application

STOP! Do not complete this application if you are a LeadingAge provider member.After submission, you will be taken to paypal to finish your membership.

Membership Options (Select One): *

Professional Membership: Single-site providers, individuals, including researchers that are interested in global ageing services and/or issues. (US $200 annually)

Organizational Membership: Includes multi-site providers, governments, associations or non-governmental organizations in the ageing services field or organizations that are interested in global ageing issues. (US $750 annually)

Business Members/Industry Partners: National or multi-national corporations and business leaders focusing on serving older adult providers and addressing the challenges and opportunities for ageing societies. (US $1,000 annually)

(NEW) Peak Association: Associations of aged care and service organizations and those who represent the interests of older adults in countries, province and regions around the world. (Dues amount is commensurate with the size and scale of the member association. A representative of the Global Ageing Network will reach out to you for additional information)

Contact Name:*

First

Last

Title:*

Organization Name:*

Operational Level:*

Organizational Function/Expertise:*

Member Information:

Street Address Street Address Line 2 City State / Province / Region Zip Code Country

Phone Number:

Email Address:*

Please answer the following questions in 300-500 words:

Why do you/your organization wish to join the Global Ageing Network?

What services does your organization offer?

How many people do you serve per year?

Newsletter

I would like to receive the Global Ageing Network’s monthly newsletter, Global Connections.

I would like to receive updates from the Global Ageing Network.

Membership Total:

Validation

I have read and agree to the terms of the Global Ageing Network's Privacy Policy. I hereby give my consent for the data entered above to be used to process my membership.