Service Coordination Training - Dering Consulting Group

Thank you for registering for the 2019 Service Coordination Classroom Training.
Please complete the form to register. And please let us know of any dietary, accessibility or other needs that you have in the Additional Registrant Information field below.

First Name*
Last Name*
Agency or Organization*
Role with Agency or Organization
Phone Number*
Email Address*
Area Agency on Aging (AAA) Affiliation*
County*
Food Allergies or Preferences (gluten-free, vegetarian, etc.)
Please select the location for your registration*
- December 5th & 6th 2024 | Northampton County Park Plaza Senior Community Center | 1800 Sullivan Trail, Suite 140 Easton, PA 18040| 610-253-8271
  *The Northampton County session is full. Your name will be placed on a waiting list if you register for this session.
- January 27th & 28th 2025 | Crawford County | Active Aging Center | 1034 Park Ave, Meadville, PA 16335 | 814-336-1792
- April 3rd & 4th 2025 | York County |York County Area Agency on Aging | 2401 Pleasant Valley Rd |York, PA 17402 | 717-771-9610
  *The York County session is full. Your name will be placed on a waiting list if you register for this session.
- April 22nd & 23rd 2025 | Jefferson County | Heritage House Senior Center | 4 Sylvania Street | Brookville. PA 15825 | 814-849-3391
I am . . .*
- Certifying for the first time.
- Re-certifying.
Would you be able to present the HSIM program in a language other than English?*
- Yes
- No
In which language would you be able to present the HSIM program?