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This form is no longer active. Please copy and paste this address into your browser window for a redirect to the 2016 contact form. https://www.surveymonkey.com/s/SCOSA2016

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* 1. Contact Information

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

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* 3. Please include names of all people registering for each event and you will be contacted with a confirmation email.  If you do not add the names of those you want to register they will not be registered. Note that some of the workshops meet multiple times.  When you register, we hope you are making a commitment to attend all meetings to complete your training in that course. SCOSA has lots of other programs that are not listed here because they do not require preregistration. Please see our Calendar of Events page on the SCOSA website for a complete listing.

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* 4. Please enter any questions you might have.

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* 5. Our Older Adult Education offerings are free unless otherwise noted. We are partially funded under the Older Americans Act of 1965, as amended. Federal law mandates that we accept donations for services provided. Any donation received will be used for future services.  Your answers to the following questions are not mandatory,  however, they help us determine eligibility for program funding.  Your answers will be strictly confidential.

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* 6. Annual Earnings

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* 7. Race and Ethnicity

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