Membership Application Form

"*" indicates required fields

Membership Category: Choose One*

Voting Members are actively engaged in carrying our our philanthropic programs as well as the fund raising these programs require. Professional Members shall be employed or carry academic units or have a child under age 18.

Voting Member

Professional Member

Name*

First Last

Address*

Street Address City ZIP Code

Primary Phone*

Secondary Phone

Email*

Enter Email Confirm Email

Emergency Contact*

Name and Phone Number

How did you hear about Assistance League of Laguna Beach (ALLB)?

If you were referred by an ALLB Member, please indicate the member's name.

Interests:

In becoming a member, what skills and special talents would you like to contribute?

Community, Volunteer and Professional Organizations:

In what other organizations have you been an active member?

Employers and Positions Held:

Date of Birth*

Your date of birth - month/day/year - is required for the background check.

Pay Dues Online Now or Submit Application and Pay Dues Later: Choose One*

You may opt to continue and pay your membership dues online now or you may submit your completed application and pay your membership dues at a later date.

Continue and pay membership dues online now

Submit application and pay membership dues at a later date

Dues - Voting Membership (Quarter Year)*

Price:

Voting Membership Orientation Fee*

Voting Member One-Time Orientation Fee

Price:

Dues - Professional Membership (Half Year)*

Price:

Professional Membership One-time Orientation Fee*

Professional Membership One-time Orientation fee of $10.00

Price: