Preparation Age Workshop Series Thank you for registering. Please complete the information below:Attendee #1(Required) First Last Address for Attendee #1(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Attendee #1 Email(Required) Attendee #2 First Last Address for Attendee #2 Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Attendee #2 Email Please register me/us for the following workshop(s): AGE SMART & LIVE SAFELY IN YOUR HOME - November 1 Carol Bloom & Lynda Shrager, OTR, MSW, CAPS STAY CONNECTED - November 8 Peggy Osborne & Jennifer Plouffe, MSW FINANCIAL & LEGAL MATTERS - November 15 Myles Fisher, Esq. MAINTAIN HEALTH & WELLNESS - November 22 Michael Wolff, MD, FCAP & Jane Sanders, MSW PREPARE FOR END OF LIFE - November 29 Caitlin St. George & Mark Levine All workshops are virtual from 7 - 8 p.m.Is there a particular aspect about aging smart and living safely that you want Carol and Lynda to address?Is there a particular aspect about staying connected that you want Peggy and Jennifer to address?Is there a particular aspect about financial & legal matters that you want Myles to address?Is there a particular aspect about maintaining health & wellness that you want Michael & Jane to address?Is there a particular aspect about preparing for end of life that you want Caitlin & Mark to address?How did you hear about this series?(Required) Social media post Friend/relative Word of mouth Other There is a $10 suggested donation for each workshop. Please check your email for registration confirmation and details on how to make a contribution.
