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* 1. Your Contact Information

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.

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

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* 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.

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* 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.

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.
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