Senior Membership (50+)
Please complete this form to register. After, please ensure you follow through to PayPal to complete this transaction. Until you have paid for your membership, your membership is NOT active. Any major credit card is accepted - no PayPal account needed.
Email address *
Card Holder #1 First Name *
Your answer
Card Holder #1 Last Name *
Your answer
Card Holder #2 First Name
Your answer
Card Holder #2 Last Name
Your answer
Address *
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Postal Code *
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Phone Number *
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Are you a new or existing member renewing your membership with DQCA? (New or Renewal. If renewal, please add existing membership number) *
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Do you want to get email updates from the community? *
Do you want to hear about volunteer opportunities? *
How did you hear about the DQCA? *
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