FLASH Card

Program application summary

Note: Fields marked with a * are required.

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

To apply for the FLASH Card, you must meet the following criteria: *

You will be asked to provide proof of your disability. Please have ONE of the following documents ready to upload in order to complete and submit your application.

Please enter your first and last name *

Mailing address *

Date of birth *

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?

Select ONE (1) proof of eligibility below. Upload a digital copy of your document.

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). *

Check the box for your preference receiving additional information

How did you hear about this program?

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

Continue