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Membership Application Form

Welcome to the Ultimate Membership.

Please fill out the application below so we can better understand your needs and how we can provide personalized, comprehensive support for your lifestyle.

Personal Information

Preferred Method of Contact:
Email
Phone
Text Message

Membership Deals

What services are you most interested in? (Select all that apply):
How often do you anticipate needing our services?
Daily
Weekly
Monthly
As Needed

Lifestyle Information

Tell us more about your household:

Do you currently have household staff?
Yes
No

If yes, please specify:

How do you currently manage your lifestyle needs?
Independently
With the help of an assistant
Other concierge services
Not applicable

Philanthropy & Legacy (Optional):

Are you interested in legacy planning or charitable giving support?
Yes
No

If yes, please provide details:

Final Questions:

How did you hear about us?
Referral
Social Media
Event/Conference
Other

Payment & Terms:

Once your application is reviewed and approved, a representative will contact you to discuss membership options, pricing, and the next steps.

Preferred Membership Tier:
Luxe
Prestige
Elite

By submitting this form, you acknowledge that your information will be used to tailor services specifically to your needs. All information remains confidential.

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