To apply for membership, please fill out the form below and click submit.

Your $25 payment can be made by check payable to The Arc Quinebaug Valley & mailed to 687 Cook Hill Road, Danielson, CT 06239.

You can also make your payment with PayPal by clicking here.



First Name: First Name is required.
Last Name: Last Name is required.
Address: Address is required.
City: City is required.
State: State is required.
Phone: Phone is required.
Email: Email is required.

New members can also apply by printing and filling out this form and mailing it to The Arc:
 Membership Form