SCOSA 2019 Mailing List and Event Registration Form

Question Title

* 1. Your Contact Information

First Name

Last Name

Street Address

City

State

Zip

County

Phone: (xxx) yyy-zzzz

e-mail address

If employed, please provide position/title, employer.

Your contact information will be used to send you monthly email and periodic postal service notices of SCOSA events.

Please remember to click SUBMIT at the bottom of the page so that your information will be recorded.

Question Title

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

Add me to SCOSA mailing list
I want to receive SCOSA E-News, occasional e-mail and print updates/announcements.

Correct/change my contact information

Register for upcoming programs
Please Note: March - June programs are not available for registration. Please check back after February 1, 2019. Also, some programs don't require registration or have alternate registration procedures and are not listed below.

Other, please specify

Question Title

* 3. Register for Upcoming Programs:
Please enter your name(s) in the box adjacent to each event you wish to attend. Also, please mark your calendar - we do not e-mail confirmations or reminders. If program you're interested in is not listed it may have a different registration procedure. Please check "Older Adult Education" at www.stockton.edu/scosa.

Chair Yoga
7/1-8/19/ 2019 3pm-4pm
Pine Street Recreation Center,
25 Pine St, Manahawkin

One Stroke Painting
7/1-8/19/ 2019 10am-12pm
Stockton at Manahawkin
712 E Bay Ave, Manahawkin

Knitting & Crocheting
7/1-8/19/ 2019 12:30pm-2:30pm
Stockton at Manahawkin
712 E Bay Ave, Manahawkin

Greeting Card Making
6/28/2019 12:00pm-1:30pm
Stockton at Manahawkin
712 East Bay Ave., Manahawkin, NJ 08050

Greeting Card Making
7/26/2019 12:00pm- 1:30pm
Stockton at Manahawkin
712 East Bay Ave., Manahawkin, NJ 08050

SoulCollage Workshop- NOTE LOCATION CHANGE
7/11/2019 10:30am-1:30pm
Stockton University, TRLC
101 Vera King Farris Dr., Galloway, NJ 08205

Time to Tell Memoir Writing - NOTE DATE CHANGE
6/27/2019 12:00pm-2:00pm
Stockton at Manahawkin
712 East Bay Ave., Manahawkin, NJ 08050

Time to Tell Memoir Writing
7/25/2019 12:00pm-2:00pm
Stockton at Manahawkin
712 East Bay Ave., Manahawkin, NJ 08050

Death Cafe
7/31/19 2:00pm-4:00pm
Stockton University TRLC, 101 Vera King Farris Dr., Galloway

Question Title

* 4. Basic Information about you:
SCOSA programs are free unless otherwise noted. We are partially funded under the Older Americans Act of 1965, as amended, which requires us to collect basic demographic information from you. 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!

We are also required to inform you that we gratefully accept donations for services provided. Donations will support ongoing programming. To donate go to www.stockton.edu/scosa and scroll to the bottom (Supporting SCOSA) section.

Age

If you have any general questions about SCOSA, please email SCOSA@stockton.edu.

If you have any specific questions about any of the Older Adult Education programs, please email Gina.Maguire@stockton.edu.