ORGANIZATION APPLICATION

"*" indicates required fields

1Organization

2Account Details

3Primary Contact

4Membership

Thank you for your interest in a TimeSlips organizational membership! Please contact TimeSlips about your interest in our Organizational Memberships. Go here to fill out the a Membership Inquiry form and our TimeSlips staff will contact you to learn more about your organizational needs and begin the process of onboarding your team. Once you have spoken to a team member, we will have you fill out the Membership Application form.

Organization Information

Fill out the form to begin the application process. Once we receive your application a TimeSlips employee will contact you to review your responses and finalize the process.

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Your Organization*

Please confirm that this is the organization that you provided.

Organization Name

Please confirm that this is the organization that you provided.

Org Not Listed

This is not my organization

Oops! It looks like we didn't find your organization name in our database. Please contact info@timeslips.org, so that we can update your account details and be sure to process your application correctly. Thank you.

Sorry for the inconvenience. Please contact info@timeslips.org if this is not your organization, so that we can update your account details and be sure to process your application correctly. Thank you.

Organization Name

Account Details

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Website

Social Media Handles
Please share your organization's social media handles (please provide handle only -- not the full url)

Facebook

Twitter

Instagram

TikTok

Organization Type

My Organization Is:*

Senior Service Providers (CCC)

Select which type of organization describes you most. Select all that apply.

Skilled Nursing

Assisted Living

Adult Day Services

Home Care Agency

Memory Care Center

Independent Senior Living

Senior Centers

Artist Communities (CCC)

Select which type of organization describes you most. Select all that apply.

Arts Organizations

Museum

Government (CCC)

Select which type of organization describes you most. Select all that apply.

Local/City

State

County

Federal

Museum

Library

Educational Organizations (CCC)

Select which type of organization describes you most. Select all that apply.

Afterschool Program

High School

Undergraduate

Graduate

Youth Groups

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Creative Community Type

Select which type of organization describes you most. Select all that apply.

Skilled Nursing

Assisted Living

Adult Day Services

Home Care Agency

Memory Care Center

Independent Senior Living

Senior Centers

Afterschool Program

High School

Undergraduate

Graduate

Youth Groups

Arts Organizations

Museum

Local/City

State

County

Federal

Library

No. of People Served

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No. of People Served

Primary Contact

Please provide the primary contact for the organization. This person will be listed as the Lead for the Organization membership and billing information and be provided a Free Membership to TimeSlips.

Name*

First Last

Title / Role

Email*

Email Type

Phone (required)*

Phone Type

TimeSlips Free Account
TimeSlips provides all prospective clients free access to our Friends & Family online training as well as our monthly newsletter. Your email is your username. You will be sent an email to verify your email and set up a new password.

Membership

What are your organization's goals?

What are your organization's goals for our creative engagement programs? Select all that apply.

Increase # of Volunteers

Improve Volunteer Experience

Improve Family Engagement

Improve Family Engagement Experience

Increase # of Creative Engagement

Improve Elder Engagement Experience

Increase # of Partnerships

Hold Public Celebration

Implement Sustainable Creative Programming

How did you hear about TimeSlips?

Referred By

What impact are you hoping for?

What impact would you like TimeSlips to have within your organization and for the people you serve?

What membership level are you interested in?*

Which Membership Plan best fits your organization's size and needs?

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Member Level

Mapped to Salesforce Member Level on Opportunity

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Member Origin

Mapped to Salesforce Member Origin on Opportunity

Up to 12 Individual Certifications on our core technique
50% discount on professional development events
15 hours of consultation to develop your program
Promotion of your organization on TimeSlips website

Up to 6 Individual Certifications on our core technique
25% discount on professional development events
5 hours of consultation to develop your program
Promotion of your organization on TimeSlips website

Would you like to be displayed on our website?

If your organization becomes certified, would you like to have your organization's general profile (City / State / Province / Country) displayed on the website?

Yes, please display our profile if we become certified

Profile Contact Details

Which additional organization contact information would you like displayed? Select all that apply.

Website

Phone Number

Facebook

Twitter

Instagram

TikTok

Annual Membership Total

Phone

This field is for validation purposes and should be left unchanged.

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Organization Application

ORGANIZATION APPLICATION

Organization Information

Account Details

Organization Type

Primary Contact

Membership