REGISTRATION

STEP ONE: REGISTER

• First Name *
• Last Name *
• Email *
• Mobile Phone Number *
• I WANT TO OPT INTO RECEIVING TEXT MESSAGE REMINDERS
  OPT IN

STEP TWO: CHOOSE YOUR SCHEDULE

• 2020 LONG TERM CARE WEEK: DAY ONE
  - Select a Value - Yes No
• 2020 LONG TERM CARE WEEK: DAY THREE
  - Select a Value - Yes No
• 2020 LONG TERM CARE WEEK: DAY TWO
  - Select a Value - Yes No

SUBMIT