Wise Aging Group Application
Are you a Temple Sinai member?
Yes
No
I am interested in being a Temple Sinai member.
First Name
Last Name
Preferred Pronouns
Please select...
She/her/hers
He/him/his
They/them/theirs
Ze/hir/hirs
Email Address
Preferred Phone Number
Back Up Phone Number
Your Age
Tell us why you would like to participate in a Wise Aging Group:
Please let us know if there are any diversity considerations about yourself that you wish to have taken into account.
Is there anything about your current situation that you think we should know (e.g., upcoming travel, medical considerations, other current challenges)?
Contact Information