During this difficult time of uncertainty, your Senior Citizen Council of Cobb County (SCC) is concerned about the well-being of our senior citizens and would like to see if you need any assistance.  Please take a few minutes to answer some brief questions to let us know if we can help you in any way.  If you have questions or concerns, you can always contact us at info@seniorcitizencouncilofcobb.org Thank you!

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* 1. What is your age?

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* 2. Do you live...

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* 3. Do you need a referral for assistance with the following?

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* 4. Would you like to receive a periodic call from an SCC member to check on you?

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* 5. Do you need information on obtaining an absentee ballot for this upcoming election?

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* 6. Prior to this Coronavirus issue, did you attend and/or participate at a Cobb County Senior Center?

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* 7. The Senior Citizen Council of Cobb County is:  (please select all that apply)

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* 8. Are you interested in learning more about the Senior Citizen Council?  

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* 9. Which issue is the most important to you?

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* 10. Is there anything else you need help with that has not already been mentioned?

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* 11. Would you like to receive the Senior Citizen Council's monthly Bulletin?

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* 12. What is your name? (Optional)

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* 13. What is your zip code

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