Home > Events > Connect > WHC Seniors Lunch & Learn: Your Aging Journey
WHC Seniors Lunch & Learn: Your Aging Journey CONTACT INFO First Name Last Name Cell Phone Email Address Street Address City StatePlease select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Puerto Rico Virgin Island Northern Mariana Islands Guam American Samoa Palau Zip Code WHC Member?YesNo Add additional guests?YesNo ADDITIONAL GUESTS First Name Last Name Guest Count ACCOMMODATIONS Do you need any accommodations to allow full participation in this event?YesNo What accommodations do you need? DIETARY CONCERNS Please let us know if you have any dietary concerns WHC should be aware of.Gluten-Free (cross-contamination OK)Gluten-Free (cross-contamination NOT OK)VeganAllergy/sensitivity to specific food/ingredientOther What are you allergic to? Other - Please expand. TOTAL COST Subtotal $ Admin Code (Staff Use Only)Please select... No Yes Enter Admin Code Amount Due Today $ Would you like to make an additional donation to the Lewis S. Wiener Annual Fund to support more programming like this? Enter the amount below. $ This donation is from: Total Amount $ Refund policy PAYMENT METHOD How would you like to pay your bill?Credit Card (includes 3% fee)ACH (Direct Bank Debit - No fee) CREDIT CARD INFORMATION To help defray some of WHC's credit card processing costs, a 3% fee has been added to your credit card payment. Please note that ACH payments do not include this fee. Fee Amount $ Grand Total $ First Name on Card Last Name on Card Credit Card Number Expiration MonthPlease select... 01 02 03 04 05 06 07 08 09 10 11 12 Expiration YearPlease select... 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 CVV Different billing address?Please select... No Yes Billing Street Billing City Billing StatePlease select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Puerto Rico Virgin Island Northern Mariana Islands Guam American Samoa Palau Billing Zip Code ACH INFORMATION Bank Routing Number Bank Account Number Bank Account TypeCheckingSavings Bank Name Account Holder's Name Different billing address?Please select... No Yes Billing Street Billing City Billing StatePlease select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Puerto Rico Virgin Island Northern Mariana Islands Guam American Samoa Palau Billing Zip Code Publicly Hidden Fields Payment Section Hide Payment InfoHidden Portal Pre-Fill Fields Account ID Contact ID Outreach/Event Pre-Fill OutreachID DesignationID Auth.net Connector Billing Info Gateway Address Gateway City Gateway State Gateway Zip Gateway Totals Gateway Quantity Gateway Amount Authnet_Hidden_Fields Type something if you're a spambot
Wednesday, March 18
11:00 am - 1:00 pm
Temple
Becca Cook
