Disability Options Network

My Life, My Choice

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Disability Options Network Membership Form

Disability Options Network's primary goal is to empower people with disabilities to live as independently as they choose with the help of a strong grassroots advocacy organization. We strive to provide independence and empowerment at a systemic level as well as at an individual level, and frame the issues as civil rights for all people with disabilities.

Our membership dues are two dollars a year, which helps with the cost of mailing information to members about meetings and ballots to elect our board of directors.

Fill out our simple membership form to join Disability Options Network. All fields marked with an * are required.

join don:

First Name:*

Last Name:*

Address 1:*

Address 2:

City:*

Pennsylvania County:*
Note: DON Membership is limited to residents of Beaver, Butler, Lawrence and Mercer Counties in Pennsylvania.

Zip Code:*

Phone Number:*

E-mail Address:*

Member Type:

Consumer Member
Supporting Member

Learn about our different classes of membership.

Volunteer:

Would you like to do some volunteer work for Disability Options Network?
Yes No

If you selected "Yes", please select the area(s) you'd be interested in helping with:

Answer phones:
Yes No

Typing:
Yes No

Help with mailings:
Yes No

Computer training:
Yes No

Computer repair:
Yes No

Peer support:
Yes No

Driving:
Yes No

Maintenance:
Yes No

Other:
Yes No

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When you click on the "Submit" button, you'll be prompted to print a copy of your membership information. Please mail a copy of your information to Disability Options Network and include your first year membership dues of $2.00.

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Disability Options Network | 101 S. Mercer St. Suite 102 | New Castle, PA 16101