Join Our Island Club on Martha's Vineyard

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	Any year-round island resident 18+ can join Our Island Club. In addition, a teen family member can be added to the membership (Additional Card)
	Renewing and New Members must meet one or more of the Residency criteria below
	Applications will not be processed unless completed in full. All membership applications will be verified by Our Island Club
	New Memberships are completed online, by mail, at Educomp, Mosher Photo, Conroy Apothecary/OB or Homes on Martha's Vineyard/ED
	Renewing Memberships are completed online or by mail (not at Cronig's)
	Renewing memberships need not provide a new photo. All photos are on file.
	SCROLL DOWN THIS PAGE TO VIEW MEMBERSHIP FORM
NEW MEMBERS
	Complete the online Membership Form, choose a payment method and submit.
	Mail or E-mail to us here head and shoulders photo(s)
	Include your check, if you've chosen that payment option.
	Mail to: Our Island Club PO Box 1323 West Tisbury, MA 02575

RENEWING MEMBERS
	Complete the online Membership Form, choose a payment method and submit.
	Include your check, if you've chosen that payment option.
	Mail to: Our Island Club PO Box 1323 West Tisbury, MA 02575
Membership is valid for One Year




Our Island Club Membership Criteria
Vote On Island (Please indicate town):

Own or operate Island business (Please indicate business name):

Work on the Vineyard for at least 6 consecutive months of the year (Please indicate employer):

We will take into consideration work/professional service that contribute to the year-round community that may not be provided in 6 consecutive months



Member Name
Spouse/Family Member
Other Family Member
Company Name (For Employee-based memberships)
Mailing Address
Town/State/Zip Code
Home Phone
Daytime Phone
E-mail (For our internal use only)

Charity Donation Choice (Please select your local charity. If this is not completed, donation will go to scholarship programs)	Click here to see previous Community Contributions
	Our Island Club Youth Programs Fund
	Children are our future. In the Club's ongoing effort to build community, we are creating Our Island Club Youth Programs Fund. This fund will support education, health and wellness programs for year-round youths with preference given to children 2-11 of low income families. The fund will be established with the Permanent Endowment of Martha's Vineyard. We are asking each member to donate what they can, as little as $5.00. This contribution is in addition to the 20% of your membership that is donated to the charity of your choice. Those contributions will total more than $400,000.00 by the end of 2014.
Membership Selection:
	Individual $89
	Family (2 cards) $109

	Senior (ages 65+) $59
	Senior Family (2 cards) $79
	Blended Family (1 Senior, 1 Non-Senior) $99
	Member Business Individual $69
	Member Business Family $89
	Member Business Employee $79
	Member Business Employee Family (2 cards) $99
	Replacement Card $5
Renewing? Your Membership#:
Additional cards (teen with driver's license):
	$20 each.
Card/FOB Selection:
	Membership card (Free)
	Keychain membership card (Free)
	Membership card & keychain membership card- $3.00 ea.
	Select number of combos you would like
Combo #1 Name:
Combo #2 Name:
Yes, I would like to donate to Our Island Club Youth Fund:
	$5
	$10
	$25
	$50
	$100
Additional Amount:


Paying by:	Check
	Credit Card (Visa, MasterCard, Discover, Amex) We do not accept PayPal payment. If paying by credit card, you will be redirected to the payment page upon submitting this form.
	Auto-Renew: Never loose a day of savings! We will contact you for your credit card information. It will be stored in our secure database.
Comments/Suggestions?

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