Gold Card

Here are things to consider before you begin: This application may take up to 10 minutes to complete.

To be eligible for the GOLD card, you must be 60 years of age or older *

On the next page we’ll ask you about each member of your household. Please include only those over 60 years old.

Enter the first name of each household member over 60 years old, including yourself. *

Mailing address *

Please enter your 10 digit phone number. *

Email address

What is your preferred language? *

What is your race?

Are you of Hispanic, Latina/Latino/Latinx or Spanish origin?

Applicant’s Release & Certification: I verify that all the statements I have made in this application are true and accurate to the best of my ability. I understand that Age Friendly Seattle shall have the right and opportunity to verify my eligibility for a FLASH or GOLD Card. I understand that if any of the statements made on this application form are false or inaccurate, I will lose the privileges granted by the FLASH/GOLD Card and may be subject to criminal prosecution in accordance with Washington State Law for theft (RCW 9A.56.020). *

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How did you hear about this program?

Please select the Review button and then Submit to complete your application.