Adventures in Lifelong Learning Fall Pilot Course and Event Registration

Please use this form to register for the Adventures in Lifelong Learning fall pilot courses. Each person must complete this form separately.

Adventures in Lifelong Learning is a membership-based program of the La Roche University Center for Lifelong Learning. The program is for adults 50 and better who want to continue learning while expanding their social networks through shared intellectual experiences. Renowned faculty, interactive classes, and exciting lectures and events offer opportunities for members to grow intellectually, socially, physically and spiritually.

The full Center will launch in the spring, but we want to pilot a few courses to gauge interest and gather feedback on subjects offered, presentation styles, timing, and other logistics.

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your street address?

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* 4. What is your 5-digit zipcode?

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* 5. What is your phone number?

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* 6. What is your email address (please write "N/A" if you do not have one)?

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* 7. How did you hear about these courses and events?

Email from La Roche University Center for Lifelong Learning

From LRU staff or faculty

From independent living facility or residence (please list which one below)

Church (please list which one below)

Other or description from above (please specify)