AVSP- New Homeowner Membership Request Form
Please allow 3-5 business days for processing all membership request

This form is for NEW HOMEOWNERS only (not for requesting replacement cards for existing homeowners, please email AVCA@ashburnvillage.org for replacement cards

**Membership cards allow residents to have access to the Pools AND the Gym

TENANTS: Please email member services at:  AVCA@ashburnvillage.org for membership card requests
 (Please allow 3-5 business days for processing all membership request)

I/We acknowledge that the membership and facility‑use rules are available online and agree to comply with them.
Sign in to Google to save your progress. Learn more
Are you a Ashburn Village homeowner?
 ( If you are a tenant please do not complete this form, send your lease to AVCA@ashburnvillage.org
 *
Do you already have an existing membership card?
If yes, please do not fill out this form. (Email AVCA@ashburnvillage.org for replacement cards)

***PLEASE DO NOT USE THIS FORM TO REQUEST POOL GUEST PASSES. 
(All pool guest passes will load AUTOMATICALLY to the membership cards when the pools.)



 *
Captionless Image
Required
Property Address: *
MEMBERSHIP QULIFICATIONS:
Each household is allotted TWO adult members (26 years of age and older) and all dependents under 26 residing on the property can be added to the membership.

** Members over the age of 6 are required to have their own pass.

If there is only 1 member of the household, please skip to the last page and select submit.
1st Adult:
If there is only 1 member of the household, please skip to the last page and select submit.
First, MI, Last Name: *
Date of Birth: *
Email Address: *
Phone Number: *
Card Preference *
2nd Adult:
If there is only 1 member of the household, please skip to the last page and select submit.
First, MI, Last Name:
Date of Birth:
Email Address:
Phone Number:
Card Preference
Clear selection
Dependent:

  • If there are no additional members that need to be added, please skip to the last page and select submit.
First, MI, Last Name:
Date of Birth:
Card Preference
Clear selection
Dependent:

  • If there are no additional members that need to be added, please skip to the last page and select submit.
First, MI, Last Name:
Date of Birth:
Card Preference
Clear selection
Dependent:

  • If there are no additional members that need to be added, please skip to the last page and select submit.
First, MI, Last Name:
Date of Birth:
Card Preference
Clear selection
Dependent:

  • If there are no additional members that need to be added, please skip to the last page and select submit.
First, MI, Last Name:
Date of Birth:
Card Preference
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Ashburn Village Community Association.

Does this form look suspicious? Report

Google Forms