I understand that my name will be placed on a waiting list for the type of accommodation I have requested, provided my application is accepted by Arbor Acres. I understand this application is a preliminary step in the consideration of my acceptance as a resident and does not make a commitment on either my part or that of Arbor Acres.

I understand that it is Arbor Acres’ policy to conduct a sex offender screening to protect the safety of its residents, employees, and guests, as part of its admissions review process. I also understand that should that screening show that I am identified as a sex offender, Arbor Acres will deny my admission on that basis. My signature below is my consent to this screening.

I declare the answers provided, and consents agreed to, in this document to be true and I authorize Arbor Acres to verify with any person or agency the accuracy of the information provided on this form and its accompanying documentation. The provision of false or intentionally misleading information can impact my admission to Arbor Acres.

I understand the $1000 per person fee will become a credit towards my entrance fee if I do move to Arbor Acres. I understand the $1000 per person fee is non-refundable if I do not move to Arbor Acres.

Please mail fee to:
Arbor Acres United Methodist Retirement Community, Inc.
1240 Arbor Road, Winston-Salem, NC 27104
(336) 724-7921