Welcome Center Membership Application Step 1 of 2 50% Contact InformationName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email* Phone*Additional Household MembersName #1Name #2Name #3Name #4Name #5Name #6Why do you want to be a member?What are your hopes and ideas for Welcome Center activities and events?Optional Demographic InformationWe at L'Arche welcome diversity in our community. In order to know who is participating with us, we ask you to please provide the following information. We use this in our grant applications and to inform our outreach efforts.Which categories best describe the age ranges of your household? (check all that apply) Preschool Grades K-5 Grades 6-8 Grades 9-12 Transition Students College Students Adults Prefer not to answer. Number of Preschool Children*Select One12345Number of Grades K-5 Children*Select One12345Which categories best describe the ethnicity of your household? (check all that apply) African American/African/Black/Caribbean Asian/Pacific Islander Caucasian Hispanic/Latino Native American Other Membership InformationChoose your membership level:*Cosmos - $75/quarter, $300/year (3 Social Events per month)Sunflower - $150/quarter, $600/year (3 Social Events + 2 Classes per month)Dahlia - $240/quarter, $960/year (Unlimited)Choose your membership/payment frequency:*Annual membership paid in fullAnnual membership paid monthlyQuarterly membership paid in fullQuarterly membership paid monthly I am interested in a scholarship. Scholarships are available for the Cosmos and Sunflower membership levels. If you checked the scholarship box, please complete the Scholarship Application (link is provided after you submit the Membership Application). Don't make any payment at this time. We will contact you about your scholarship amount and then you can pay for your membership.Return Policy: All Welcome Center memberships are non-refundable and non-transferable. All donations to L'Arche Tahoma Hope are non-refundable.* I accept the Return Policy. Payment InformationPayment Method* I will mail my check to L'Arche Tahoma Hope: 12302 Vickery Ave East, Tacoma WA 98446. I will pay by credit card below. I intend to apply for a scholarship so I am not submitting any payment now. Annual Membership, paid in full (choose your level)*Cosmos - $300Sunflower - $600Dahlia - $960Annual Membership, paid monthly (choose your level)Cosmos - $25Sunflower - $50Dahlia - $80Quarterly Membership, paid in full (choose your level)Cosmos - $75Sunflower - $150Dahlia - $240Quarterly Membership, paid monthly (choose your level)Cosmos - $25Sunflower - $50Dahlia - $80Total $0.00 Credit CardThis field is hidden when viewing the formJoined MM slash DD slash YYYY This field is hidden when viewing the formLast Payment MM slash DD slash YYYY This field is hidden when viewing the formNext Payment Due MM slash DD slash YYYY This field is hidden when viewing the formExpires MM slash DD slash YYYY