Family Weekend Registration Form 2018
Please complete ONE registration form per Villager Family BY AUGUST 31st.
Questions? Kathy Lindeman, (678) 765-4805; kathy.lindeman@annandale.org
Email address *
Villager Name *
Your answer
Attendee #1 Name & Relationship to Villager *
Your answer
Attendee #2 Name & Relationship to Villager
Your answer
Attendee #3 Name & Relationship to Villager
Your answer
Please indicate your attendance at the following events:
Family Luncheon *
Friday, September 28, 11:30AM
If you answered yes to the question above, how many people will be attending?
Do NOT include your Villager in this number.
Your answer
Fall Festival *
Friday, September 28, 12:30PM
Dinner for Families *
Friday, September 28, 4:30PM
If you answered yes to the question above, how many people will be attending?
Do NOT include your Villager in this number.
Your answer
Cocktail Reception: Meet the Board *
Friday, September 28, 6:00PM
If you answered yes to the question above, how many people will be attending?
Do NOT include your Villager in this number.
Your answer
Breakfast *
Saturday, September 29, 8:00AM
If you answered yes to the question above, how many people will be attending?
Do NOT include your Villager in this number.
Your answer
The State of Annandale Village Address *
Saturday, September 29, 9:00AM
Family Council Meeting *
Saturday, September 29, 11:00AM
Lunch at Berry Dining Hall *
Saturday, September 29, 12:00PM
If you answered yes to the question above, how many people will be attending?
Do NOT include your Villager in this number.
Your answer
Special Needs Trusts & Estate Planning *
Saturday, September 29, 1:30PM
Advanced Directives & Guardianship *
Saturday, September 29, 3:00PM
Dinner and Awards Program *
Saturday, September 29, 5:00PM
If you answered yes to the question above, how many people will be attending?
Do NOT include your Villager in this number.
Your answer
Individual Appointments with Staff
Please indicate your preferred date(s) and staff member(s) you would like to meet with. We will reach out to you to schedule an exact time.
Thursday, September 27, 9AM-4PM
Friday, September 28, 7:30AM-12PM
Monday, October 1, 8:30AM-12PM
ADAM POMERANZ, CEO, President
BRANDI MEADOWS, Chief Programs Officer
LAURA GOURLEY, Chief Financial Officer
NANCY TRUJILLO, Personal Care Home & Day Program Administrator
LADONNA HAGAN, Nursing Home Administrator
NANCY BOSTER, Social Services Manager
WENDY MEJIA, Director of Health Services
GENA BOYLE, Program Center Manager
PAM SHIPMAN, Assisted Living Center Administrator
KENDALL BURNETTE, Case Manager
KAREN BELGRAVE, Case Manager
OTHER
A copy of your responses will be emailed to the address you provided.
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