Residential Living Application

Following is the application for residency at the Elks National Home. We have placed this on our website for your convenience. However, it is very important that you follow certain guidelines in using the form.

Availability in some accommodations is limited at times. You should call our office (1-800-552-4140) and speak with a Marketing Counselor to find out availability before you complete and submit the application.

Be sure you have the most up-to-date version of the application, before you complete it. If you download the application and hold it for a time before using it, check the website to see if it has been updated. Each section has the revision date at the very end of the section. For example, "ENH/ss_app.frm/6-99/10-99" identifies the form as the Self-Sustaining Application and gives revision dates of June 1999 and October 1999, with the October 1999 revision being the latest.

The application cannot be completed on-line. You must print it out, complete it, and then mail it to us at:

Elks National Home

931 Ashland Avenue

Bedford, VA, 24523

NOTE: In order to download the application form, you must first download a FREE software called Acrobat Reader if you don't already have this software on your computer. This software is used to read .PDF files. You can download this software by clicking the link below for Acrobat Reader.

Thank you for your interest in residing at the Elks National Home. If you would rather receive an application by mail, or if you have any questions at all, feel free to e-mail us at ENHome@aol.com, or call 1-800-552-4140 between the hours of 8:00 a.m. and 5:00 p.m. Eastern Time.