Membership Application To apply for membership please complete all questions. Please enable JavaScript in your browser to complete this form.Type of membership * New MemberRenewal MembershipThis is a membership for a/an *I am a Professional or Business Person in the field. Fee for $50 for my professional dues.I am a Parent/Relative of an individual with an intellectual or developmental disability or am otherwise interested in supporting the activities of The Arc of Central Kentucky. Fee for $25 for my personal/family.I am an Individual with an intellectual or developmental disability. Fee for $10 for my personal dues.I am a Student interested in supporting the activities of The Arc of Central Kentucky. Fee for $10 for my dues.Name *FirstLastEmail *Phone *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePayment Type *Check/Money OrderCredit CardPaypalStripe Credit CardCardName on CardTotal$ 0.00Submit