Personal Information

First Name:
Last Name:
Age:
<18
18-29
30-39
40-49
50-59
60-69
70-79
80+

Minors under the age of 18 are not eligible for Membership in Vivos without an accompanying Adult/Guardian Membership Application.

Home Address:
City:   State:
Zip:
Country:
Phone:
Home
Cell
Email:
# People in your group:
Promo Code: Enter "000" if none.
How did you find Vivos?

Skills & Expertise

Check each professional area/field that you have

expertise in, or a good working knowledge of.

Physician
Nurse/Aide
Dentist
Psychologist
Pharmacist
Therapist
Scientist
Biotech
Chemist
EMT
Health Care
Veterinarian
Engineer
Architect
Contractor
Electrician
Mechanic
Plumber
Accountant
Financial
Electronics
Energy
Automotive
HVAC
Programmer
Communications
Transportation
Restaurant
Seamstress
Hospitality
Beautician
Executive
Educator
Farmer
Hunter
Fisherman
Skilled Laborer
Aviation
Agriculture
Musician
Artist
Administrator
Government
Fireman
Lawyer
Military
Security
Law Enforcement
Survivalist
Martial Artist
Religion

 

If you wish to make a change click reset.  Note this will reset the entire form.

Comments

Please explain, in detail, why you would like to be considered for space in Vivos. Tell us what skills and expertise you have and how you will be a benefit to a Vivos shelter community. This information will assist us in processing your application.

Correspondence

Please advise where you would like future printed documents and other printed information delivered. All other communication from Vivos will be sent to your email address, and/or when necessary, communicated by phone to the phone number(s) provided in this application. Please be certain that your spam filters are set up to accept emails from any account @terravivos.com

Official Documents:

Home Business Email
Newsletter & Other: Home Business Email
Create a Password for your Account: