Select the senior center where the participants is registering to take this course.
Choose
NYC Area 1: RAIN: Boston Road, East
NYC Area 2: East Harlem Neighborhood Senior Center
NYC Area 3: Cypress Hills Senior Center
NYC Area 3: WORD, Inc: Boulevard Senior Center
NYC Area 3: WORD, Inc: Brownsville Senior Center
NYC Area 3: WORD, Inc: Langston Hughes
NYC Area 3: WORD, Inc: Rosetta Gaston
NYC Area 4: Woodside Senior Center
Street Address *
Your answer
City, State, ZIP *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Promotional Source *
Select the type of platform used to initiate the sale.
Required
Training Progress *
Select the progress field that applies. If you are a staff-member or an intern, select the assigned program. If you are an apprenticeship enrollee, select the service or test that you have passed.
Choose
Staff
Intern
Participant: (POC) Positivity Organization of Communities (