Application Details

Contact Details

Request Received
Community Partner
This is a 12-month membership
This membership includes 1 member slot(s)

Community Partners are local businesses or service providers who support Village Collective by offering discounts or special rates to Village members. Community Partners play a vital role in helping residents age in place by expanding access to trusted services. Community Partners are not considered employees of Village Collective.

Account creation information.

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Please enter a first name
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Please enter a last name
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・8 characters minimum
・one upper case letter
・one lower case letter
・one number
・one special character (@$!%*?&)
If you input more than 0 characters your Password may not display properly


・8 characters minimum
・one upper case letter
・one lower case letter
・one number
・one special character (@$!%*?&)
If you input more than 0 characters your Confirm password (at least 8 characters) may not display properly

Please fill in your individual information.

Please fill in the below form with your company details.

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Uploading an image is mandatory
Find Company
Please enter a company name

Thank you for your interest in being a Community Partner with Village Collective!


Filling out the form as completely as possible allows us to give the best service to our members. If you don't know an answer, or if a question is not applicable to you, please write N/A. 

Please enter a value for the other option. The value cannot exceed 255 characters.

If you input more than 0 characters your Business Founded? may not display properly
Please enter a value for the other option. The value cannot exceed 255 characters.

Please enter a standard work hours
If you input more than 0 characters your Standard Work Hours may not display properly

If you input more than 0 characters your How to Request Services may not display properly

If you input more than 0 characters your Minimum Charge may not display properly
Please enter a valid number

If you input more than 0 characters your Guarantees may not display properly

If you input more than 0 characters your Special Skills may not display properly

If you input more than 0 characters your Languages may not display properly
Click here to upload a file

If you input more than 0 characters your Company discount or promotion may not display properly

Consent

This checkbox is mandatory
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