Image
Thank you for using our online form. Your contact information will be used to send you monthly email and periodic postal service notices of SCOSA events.

Please remember to click the SUBMIT button on the thank you page so that your information will be recorded.

* 1. Your Contact Information

* 2. Please indicate your reason(s) for completing this form today: (Check all that apply)

* 3. Enter your name(s) in the box adjacent to each event you wish to attend. Please mark your calendar for each you plan to attend. You will not receive an e-mail confirmation or reminder. If you don't see the program you're interested in, it may have a different registration procedure. Please check "Older Adult Education" at www.stockton.edu/scosa.

* 4. Please enter any questions you might have.

* 5. Our programs are free unless otherwise noted. We are partially funded under the Older Americans Act of 1965, as amended, which requires that we inform you that we gratefully accept donations for services provided. Donations will support ongoing programming. Also, we are required to collect basic demographic information. Your voluntary answers to the following questions help us determine eligibility for program funding and to secure future funding. Your answers will be kept strictly confidential. Thank you.

T