Join/Renew Annual Membership

 Click here to download a PDF version to Mail or Email

Online Enrollment for Annual Membership / Renewal

* Indicates a Required Field

Facility Information

* Facility Type

***In order to report accurate numbers below, please obtain this information from your admissions staff if you do not have access to it. This section is required so that we can report accurately to our funders.

* Website Access

 I do have Internet access and understand that all current program options can be found on the CAC website.

 I do not have Internet access and will need a hard-copy of available programs mailed to our Facility Address.

* Membership Level

 Platinum Level: $1,900

 Gold Level: $1,300

 Silver Level: $700





* Membership Agreement

I agree to schedule all of our Creative Aging programs through the Program Director at 200-6940. I understand that all of our programs must be scheduled during the calendar year of membership as they do not carry over. I agree to pay in full or pay per the agreed upon payment plan (below). I understand the Program Data Sheet is required following each program. I agree to complete, or make appropriate arrangements for completion, Creative Aging’s Program Data Sheet both accurately and completely, and return it as directed to Creative Aging Cincinnati immediately following every program via email, mail or fax. I understand that failure to comply may result in termination of the working relationship.

 Do you agree with the Membership Agreement?

If your form submission is successful, you will receive a "Thank you" message immediately.

Additional Information:

Payment plans available upon request

Activity Director responsible for supplying facility website for hyperlink on the Creative Aging website.

*In order for your facility to be listed in the annual printed program, forms must be returned by January 15th.

All Creative Aging programs must be scheduled through the Program Director at 200-6940. All programs must be used during the calendar year of membership as they do not carry over.

*Please note that some artists charge an additional fee on holidays which would be the responsibility of the facility. Prior to booking, the facility will be asked if they wish to pay the additional fee or choose another artist.

Our website ( is the best place to find the most current listing of program options.  If you do not have access to the website, we will provide a hard copy version of our program options. Please check the box on enrollment form to request this. Facility must fill out the provided Program Data Sheet following each performance and return via email or mail immediately following the program.

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