LifeCare Application

The application form at right is a downloadable and fillable form. To use the form, follow these instructions:

Download the LifeCare Application form to your computer.
Once saved, complete the entire application form on your computer.
Print the completed application.
Sign the completed application at the bottom.
Mail the signed application with your payment of $59.00.
Download the Membership Agreement for your records

We accept personal checks, money orders, Visa, MasterCard or Discover.

Important Information - Please Read Carefully! You cannot submit your form or pay your membership fees online. Your signed and completed form with your payment must be mailed and received by us before your membership becomes effective. Unsigned applications, applications with no payment, or payments with no application, will not be accepted.