INFORMATION SHEET

Complete this information sheet to join our regular mailing list (via email for those who have it), so you can be kept up to date on FCCRC's progress.
 
Any personal data you provide is for general planning purposes only, and will help those involved in initial planning to better understand the population interested in the project and identify individuals wishing to help in this early stage of the work.

Individual: Spouse or Partner:
Name: Name:
Gender: Male Female Gender: Male Female
Year of Birth: Year of Birth:
Date desiring entry: Date desiring entry:
(We are hoping that the project might open in 2010.)
Address and Zip Code:
Telephone1: Telephone2:
Email1: Email2:

Please list the names of any larger groups or organizations that might be interested, of which you are a member and for which you would be willing to serve as a contact person.
Please list any special skills or contacts to offer which would be of help in the planning and development process.

Please indicate if you are interested in helping with any of the following:
 
Project Planning:
Real Estate / Architectural Design:
Fundraising:
Finance:
Health Care:
Membership Development / Publicity:
Events Planning:

How did you hear about FCCRC?
What other retirement options are you considering?
What excites you most about FCCRC?
What concerns do you have?
 


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