Application

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Organization Information (to be displayed online)
Main Contact
Additional Contacts
Contact 1
Contact 2
Contact 3
Contact 4
Contact 5
Contact 6
Contact 7
Contact 8
Contact 9
Contact 10
Billing Address (if different)
Mailing Address (if different)
Additional Information
Membership Investment
Provider Members are licensed Assisted Living Communities and Personal Care Homes.

Industry Partner Members include any company or corporation that provides goods or services to the senior housing industry or has an interest or involvement in the industry but does not own, operate, or manage a senior housing community.

  • Select additional directory categories below by holding the "CTRL" key
  • Secondary categories may be subject to additional fees
 

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NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.
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Please select a membership type before submitting your application.
​Copyright GSLA. All Rights Reserved.
2774 Cobb Parkway NW | Suite 109  #359 |  Kennesaw, GA 30152
Phone: (678) 407-2060 | [email protected]