Age Friendly Worcester Sign Up Form

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Thanks for your interest in the Age Friendly Worcester! We are excited you'd like to be involved with our goal of making Worcester a livable, age-inclusive city for all. Please fill out the form below and we will be in touch with you for next steps.

Questions? Email AKrasinski@SeniorConnection.org or EBelding@SeniorConnection.org

What is your name? *

What is your email? *

What organization, church, department or business are you affiliated with in the City of Worcester? (If none, type N/A) *

If you are a resident, what neighborhood in Worcester do you live in?

What issue areas are you interested in? *

Community Support & Health Services

Outdoor Spaces & Buildings

Communication & Information (how can we help others learn about resources available?)

Civic Participation & Employment (how to get folks involved with city government, job training, etc.)

Respect & Social Inclusion (feeling included, recognized, and appreciated by the community)

Social Participation (connecting people in Worcester with one another regardless of age, ability, etc.)

Housing

Nutrition

Transportation

Other:

Required

What sub-committee do you feel most aligned with? *

Marketing & Outreach

Health, Information & Social Services

Civic Participation & Social Interaction

Transportation

Housing & Outdoor Spaces

Required

When are you unavailable during the week? (List days and times you are generally NOT available for meetings, etc.)

Submit

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