Membership Information Request

Welcome to Foster City Village!

Foster City Village is a membership based 501(c)(3) nonprofit corporation led and run by local volunteers in the 94404 Zip Code. We are dedicated to enabling older adults to live independently as we age in our homes by providing social connection, practical assistance, access to services, resources, and education opportunities, and by fostering active engagement in the community. Foster City Village does not provide emergency or healthcare services, and does not employ licensed health professionals. We are a network of neighbors helping neighbors.

Please complete the application below and let us know if you have any questions (650-378-8541). We hope you will consider joining us as either a social member or a full member receiving services provided by our screened and vetted volunteers.

Under "Additional Comments" indicate whether you are intested in a Social Membership or Full Membership (Full Membership includes services such as, drives to appointments, organizing, handyman, etc.) Thank you!

First name

Last name

Phone

Cell phone

Date of birth

Marital status

Gender

Ethnicity

Number

Street

City

State

Zip Code

Available Membership Options

Social - Individual: $175.00 for 12 months

Social - Couple: $250.00 for 12 months

Full - Individual: $365.00 for 12 months

Full - Couple: $475.00 for 12 months

First emergency contact name

First emergency contact cell phone

First emergency contact phone

First emergency contact email

First emergency contact address

First emergency contact relationship

Second emergency contact name

Second emergency contact cell phone

Second emergency contact phone

Second emergency contact email

Second emergency contact address

Second emergency contact relationship

First pet species

First pet breed

First pet name

First pet date of birth

Current Health

Mobility issues

Special needs

Home type

Employment status

Your interests what do you love doing

How did you hear about us

What interested becoming member

Additional Comments

I confirm that I have read, consent and agree to Revolutionaging’s (Helpful Village’s) TERMS OF USE and PRIVACY POLICY

Thank you for your interest

Thank you for your interest and we will be in touch with you very soon!