Penn's Village :: MEMBERSHIP

To become a Penn’s Village member, please review the Membership Agreement and complete the application below. (If you prefer, you may download the application and mail it in.)

Applicants pay membership fees to cover services provided by Penn's Village. Contributions to Penn's Village are tax-deductible; however membership fees are not tax-deductible because members receive services in return.
Although we strive to serve as many neighbors as possible, Penn’s Village cannot take the place of a health care provider, an assisted living facility or nursing home for those who require medical care or intensive custodial services.
Penn’s Village is currently accepting members who live within Old City, Society Hill and Queen Village (Vine Street to Washington Avenue and from Front Street to 8th Street). If you live outside of one of these boundaries, please contact us at 215.925.7333 or info@pennsvillage.org.

Type of Membership:	Charter Memberships include a tax deductible donation.
*1st Member Name:
Date of birth:	example: 01/01/1955
2nd Member Name:
Date of birth:	example: 01/01/1955
3rd Member Name:
Date of birth:	example: 01/01/1955
Street Address:
City:
if Philadelphia, what part of the city do you live in?
State:
ZIP code:
*Phone Number:
Cell Number:
Emergency Contact
Emergency Contact Phone:
*Email:
How do you plan to arrange payment?
We accept payment online via PayPal, or by check. What do you prefer?
Penn’s Village will continually add new services. Please let us know which are most important to you so that we will be better able to establish priorities: Routine home service such as food shopping, home repair and transportation. Organized group activities such as lectures, book clubs and social events. Health and mobility services such as advocacy and referrals to home care agencies. Financial and legal assistance such as help with wills or income tax preparation.
Do you or members of your household have a special talent to share with Penn’s Village? If yes, please explain:
Are you or members of your household available to volunteer? Yes No
AS A PENN’S VILLAGE MEMBER, I HEREBY RELEASE AND DISCHARGE PENN’S VILLAGE AND ITS EMPLOYEES AND AGENTS FROM ALL RESPONSIBILITY OR LIABILITY FOR SERVICES RENDERED BY THEM OR ANY THIRD-PARTY PROVIDER, PREFERRED VENDOR OR VOLUNTEER, AND I AGREE TO INDEMNIFY PENN’S VILLAGE AND HOLD IT HARMLESS FROM AND AGAINST ANY CLAIMS, EXPENSES OR DAMAGES, INCLUDING WITHOUT LIMITATION, COSTS AND REASONABLE ATTORNEY'S FEES, ARISING IN CONNECTION WITH ANY ACTIONS OR OMISSIONS ALLEGED TO HAVE BEEN NEGLIGENT OR WRONGFUL, WHETHER SUCH CLAIMS ARE BROUGHT BY OR THROUGH ME, INCLUDING BUT NOT LIMITED TO CLAIMS BROUGHT BY MY INSURANCE CARRIER.
*

Penn's Village
321 S. 4th Street
Philadelphia, PA 19106

Tel: 215.925.7333
Fax: 215.925.7332

"We have joined Penn's Village and find great comfort in knowing that such special and essential services are there when we don't need them and then, when we do need them. This is peace of mind, in a major way!"

-- 70-year-old Charter Member

"Thanks so much for everything! It is a great relief to me to know that I can count on you to take care of my mom, especially when I am out of town."

-- Daughter of a 96-year-old member

"With Penn's Village, I have the confidence to remain in my own home as I grow older."

-- 55-year-old Charter Member