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* 1. Please provide your first and last name:

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* 2. Please provide the first and last name of your Churchill senior(s):

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* 3. Please provide your email address:

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* 4. Please provide a contact phone number:

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* 5. Is it ok to send text messages to the phone number provided?

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* 6. Would you like to receive updates about planning  and future meetings?

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* 7. Which of the follow ways would you like to get involved?

Thank you for your interest in getting involved with senior celebration planning. You will be contacted soon with a meeting invitation and other information to join the planning process. In the meantime, please feel free to reach out to sandeebybee@gmail.com with questions.

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