WISE Interest Form

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WISE Interest Form

A Program designed to help older adults (55+) celebrate healthy aging, make healthy lifestyle choices and avoid substance use.

Event Timing: Six two hour sessions
Event Address: Please choose a location below
Contact us at (419) 214-3629 or dwashington@harbor.org

Name *

Phone number *

May we send you text message reminders?

Yes

Clear selection

What is your Zip Code *

How did you hear about us? (Ex. Organization, referral, flyer, Facebook etc.) *

Which location would you like to attend? *

Are you age 55 or older? *

Yes

Required

Submit

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