New Senior Registration Form
Hello! We're so happy that you're interested in joining us at the Longmeadow Adult Center. We use a system called My Senior Center to help us keep track of registration and attendance. This data will be entered into our My Senior Center database by a CORI'd volunteer. We will have a scan card ready for you at the front desk when the new building opens so that you can sign in when you visit us!
Other ways to prepare for the new building:
1. Be sure to join our email list. If you are on the list but haven’t been getting emails, check your junk/spam box. You can sign up for emails with this link:
This is the fastest way for you to hear updates from us.
2. Sign up for offsite/virtual programs on our website! The more participation at our programs, the better!
3. Share this form with friends and neighbors who will be new to the center, this will be one less thing to do when we open up! Thank you!
Sign in to Google
to save your progress.
Name (First and Last
Preferred Phone Number
Permission to add you to our email list?
Would you like a paper newsletter mailed to you monthly? (A digital version will be emailed to our email list.)
Emergency Contact Name AND Phone
Interested in Volunteering?
Anything extra we should know about you?
Send me a copy of my responses.
Never submit passwords through Google Forms.
This form was created inside of Town of Longmeadow.