Document 5A

Residential Membership Application

Complete all sections. Incomplete applications will not advance to Committee Review. Your information is kept confidential.

Section 1 — Applicant Information

Legal Full Name(s) *

Preferred Name / Goes By

Date of Application

Current Street Address *

City *

State / ZIP *

Primary Phone *

Email Address *

Secondary Phone (optional)

Alternate Email (optional)

Household Members

Include all adults and dependents who will reside on the lot.

Full Name	Relationship	Age	Residency

Section 2 — Intended Use & Timeline

Planned use of lot:

Primary Residence Co-Development / Partnership Long-Term Rental Other

If Other, describe planned use:

Anticipated Lot Size / Type (if known)

Estimated Build Start (if known)

Do you plan to hire a contractor, self-build, or use Pangea Design Build?

Pangea Design Build (standard) Pangea Design Build (custom) Third-party contractor (pre-approved) Self-build / owner-builder

Are you currently working with a financial institution or lender?

Yes — lender pre-qualification attached Yes — proof of funds attached No — self-funded, proof of funds attached Not yet secured (explain in Section 4)

Section 3 — Statement of Intent

In your own words, describe why you want to join the Pangea Community and how your values, skills, and life experience align with regenerative and off-grid living. Include what you hope to contribute to the community. Minimum 200 words.

Word count: 0 / 200 minimum

Section 4 — Financial Readiness

Financial information is reviewed in confidence by the Membership Committee only.

Financial verification — please indicate what you will attach or submit:

Bank or brokerage statement (last 60 days) Lender pre-qualification letter Source of funds declaration Other

Approximate liquid assets available for purchase

Approximate monthly income (gross)

Current monthly housing cost

Anticipated financing amount (if any)

Do you have any outstanding judgments, liens, or pending bankruptcies?

No Yes — I will describe on an attached note

Are you aware of the current HOA assessment range and ongoing maintenance obligations?

Yes — I have reviewed the LPA Overview (Document 07) Not yet

Section 5 — Background & Experience

Check all areas where you have relevant experience or training:

Passive solar / thermal mass construction Rainwater harvesting / cistern systems Greywater / blackwater treatment systems Solar / wind / micro-hydro energy Battery storage / inverter systems Natural / earthen building materials Permaculture design Regenerative farming / food production Animal husbandry Off-grid living (prior experience) Community / cooperative living Construction / project management Architecture / design Carpentry / trades Education / teaching Medical / healthcare Legal / governance Finance / accounting Technology / IT / smart systems Arts / culture / music

Languages spoken

Skills or knowledge you are eager to learn or develop at Pangea (optional)

Occupation / Professional Background (current or most recent) *

Section 7 — References

Provide two references who can speak to your character, values, or relevant experience. References may not be family members.

Reference 1

Full Name *

Relationship to Applicant *

Phone *

Email *

How long have you known this person? *

Reference 2

Full Name *

Relationship to Applicant *

Phone *

Email *

How long have you known this person? *

Section 8 — Background Check Authorization

Authorization
I authorize Pangea Community / Pangea Community Land Preservation Association (LPA) to obtain a background report through a consumer reporting agency for the purpose of evaluating my membership application. I understand this report may include criminal history, civil records, and identity verification consistent with applicable law.

Legal Full Name (for background check) *

Date of Birth *

I authorize Pangea Community LPA to conduct a background check as described above. Required to proceed.

Section 9 — Governing Document Acknowledgment

Indicate which documents you have received and reviewed.

07 — LPA Overview [Public] — received and reviewed 08 — Governance Summary [Public] — received and reviewed

Documents 01–04 will be provided upon provisional approval.

Section 10 — Certification & Signature

By submitting this application, I certify that:

All information provided is true, accurate, and complete to the best of my knowledge.
I understand that misrepresentation or omission of material facts is grounds for rejection or rescission of membership.
I authorize Pangea Community LPA to verify any information provided herein and to conduct a background check.
I understand that submission does not guarantee acceptance, create any right to a lot, or establish any legal interest in any Pangea Community property.

Full Legal Name (typed signature) *

Co-Applicant Full Name (if applicable)

I certify that all information provided is accurate and I agree to comply with all Pangea Community governing documents. Required to submit.

Your application will be reviewed by the Membership Committee. You'll receive a confirmation email within minutes.