Grandfamilies Leadership Online Certificate Program Registration Form
Please fill out the form below to hold your spot for the Spring 2021 course offering. The Spring 2021 course will run from February 22 through May 9, 2021. To complete your registration, you will need to process payment using our online payment link which will be provided once you submit this form. If you have any questions about the course, please contact Kelley Morris at
This program has been approved for National Association of Social Workers for 8 Social Work continuing education contact hours (Approval# 886480408-1036).
How did you hear about this certificate program? (please check all that apply)
E-mail from the UM Center on Aging
E-mail through the Brookdale Foundation RAPP Network
What is the highest level of education you have completed?
Less than high school
High school or equivalent
2 year Junior or Community College
4-year College or University
Have you participated in any online education like webinars, online classes, online support groups or conferences?
Please check all of the following technologies/computer functions that you are comfortable with:
Word processing applications like Word or Notepad
Computer-based e-mail programs like Outlook
Internet-based e-mail clients like Gmail/Yahoo/Hotmail
Web searching through search engines like Google and Yahoo!
Using social media sites like Facebook and Twitter
Opening and reading electronic PDF files from e-mails and websites
Watching videos online using websites like YouTube or Vimeo
Online webinars like GoToMeeting or Adobe Connect
Use this section to provide any additional information about yourself that you think would be helpful for our instructors and facilitators to know.
Never submit passwords through Google Forms.
This form was created inside of University of Maine System.