Membership Application

Become a PB Village Member
Thank you for your interest in joining PB Village. Our mission is to help adults 55+ in Pacific Beach stay connected, active, and supported while aging in place.

If you are age 55 or older, live in Pacific Beach, and are able to manage basic Activities of Daily Living (ADLs), we invite you to review the membership information below.

Activities of Daily Living (ADLs)
Members should be able to independently manage basic daily activities, including:

Walking and moving independently
Feeding yourself
Dressing independently
Personal hygiene and grooming
Managing bathroom needs independently
Managing bladder and bowel function
Managing your own medications

Membership Fees
As part of our launch, we are currently offering a special Founder’s Rate of $100 for the first year.

Future membership pricing will be:

$240 annually for an individual
$300 annually for a household (2 individuals)

What Happens Next?
Once your application is submitted, a PB Village team member will contact you within 3–5 business days to review your application and answer any questions.

Your Information

First name

Last name

Phone

Cell phone

Date of birth

Marital status

Gender

Address

Number

Street

City

State

Zip Code

Available Membership Options

Household: for 12 months Individual: for 12 months

Additional Information

First Emergency Contact

First emergency contact name

First emergency contact relationship

First emergency contact cell phone

First emergency contact phone

First emergency contact email

First emergency contact address

Current Health

Mobility issues

Special needs

Home type

How long have you lived in the city

Your interests what do you love doing

Special expertise

How did you hear about us

What made you interested in becoming a member?

Additional Comments

I confirm that I have read, consent and agree to Revolutionaging’s (Helpful Village’s) TERMS OF USE and PRIVACY POLICY

Thank you for your interest

Thank you for contacting us — it’s a pleasure to connect! Our team is committed to providing friendly, professional assistance, and we’ll be reviewing your message right away. You’ll hear back from us soon.