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Alliance on Aging and Vision Loss
2021 Membership Form

Thank you for joining AAVL or renewing your membership. Membership dues are payable on a yearly basis.  You may either use the online Membership Form below or download the AAVL Membership Form and mail as described below.

  1. If using this downloadable AAVL Membership Form, please return, along with check or money order to Kathy Gerhardt, AAVL Treasurer, 2456 Edgewater Drive, Poland, OH 44514-1724.  For questions or further information contact Kathy Gerhardt, AAVL Treasurer at 304-283-7424 or; or Jeff Thom, AAVL President, at 916-995-3967 or
  2. If using the online Membership Form below, complete all required fields and on the confirmation page submit your dues using the PayPal button. 
  3. AAVL is an IRS 501(c)(3) non-profit charitable organization and donations are tax deductible. If you desire to also make a tax deductible donation, you can do that on the confirmation page following payment of your membership dues, or go directly to the AAVL donations page.


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AAVL Membership Form
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