Join or Renew Today

Membership 

Single:  $35
Couple: $60

A couple MUST live at the same address.  

 

We welcome caregivers to bring their clients to OASIS.  Caregivers do not need to be a member, but they will not receive member benefits without a membership. Below are membership costs for caregivers:

Single Member + Caregiver (Same address) — $60
Single Member + Caregiver (Different address) — $70  ($35 each)

 

Pay dues online

    I am a ...

    I am paying dues for ...

    Contact information

    Your name

    Spouse name

    Home phone

    Your e-mail

    Your cellphone

    Spouse e-mail

    Spouse cellphone

    Veteran status

    I am a veteran

    Spouse is a veteran

    Personal information


    The information asked for below is already on file from my previous membership and should be accurate and current.
    (If in doubt, you may fill in any parts of this form that you believe need updating.)

    Address

    City

    State

    ZIP

    My date of birth

    Spouse date of birth

    Live alone?
    yesno

    Volunteer interest

    Are you willing to volunteer?
    yesno

    Is your spouse willing to volunteer?

    yesno

    Areas of volunteer interest?

    List two emergency contacts

    First contact name

    Phone

    Relation

    Second contact name

    Phone

    Relation

    Spouse's first contact name

    Phone

    Relation

    Spouse's second contact name

    Phone

    Relation

    Doctor contact

    Doctor name

    Phone

    Spouse's doctor name

    Spouse's doctor phone

    Please let us know of any medical concerns we should be aware of in case emergency services are called. (This information will never be shared outside of staff and emergency services.)

    Newsletter

    How would you like to receive your monthly newsletter?

    By e-mailBy regular mail

    Disclaimer

    I agree to hold free and harmless Orcutt Area Seniors in Service, Inc. and the Orcutt School District from any liability, loss, claims or damages that may be incurred while engaging in programs or services at the Luis OASIS Senior Center.

    I agree

    Click “Proceed to checkout” and then click the PayPal button to pay your membership dues.

    If you prefer to mail or deliver your membership dues in person, please print out the form and send it to: OASIS Inc., P.O. Box 2637, Santa Maria, CA 93457. Or deliver in person to the center at: 420 Soares Ave, Old Town Orcutt, CA