Senior Coalition Application 2024
The Senior Coalition of Stanislaus County is asking current and interested members to take a moment to complete the following application. This application will provide up-to-date contact information for the SCSC Coordinators to be able to update the email list along with the website. SCSC is composed of members who are striving to enhance the physical, mental, and social well-being of older adults and person with disabilities, reduce fall risk for seniors, and persons with disabilities, and assist older adults to remain independent. Members offer services in/or live in Stanislaus County and want to be a part of a collaborative community effort through advocacy, education and coordinated services.
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Organization/Business Name *
Contact Person (First and Last Name) *
Title of Contact Person *
Phone Number *
Email Address *
Mailing Address *
City *
State *
Zip Code *
How did you hear about us? *
What is your preference for the delivery of the monthly meeting? *
Are you interested in volunteer opportunities? *
Are you familiar with the Master Plan for Aging (MPA)? *
What is your area of expertise to assist in the focus for the Master Plan for Aging (MPA)? *
What senior services do you provide (check all that apply) *
Required
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