Powerful Tools for Caregivers

Please only register if you plan to attend all or most of the six weeks. Space is limited we can only allow a maximum of 12 people per session.

Please contact Patricia Soos by phone or email if you have any difficulty registering online or have any questions.

Contact Patricia Soos at
(203) 785-8533 x. 3159, psoos@aoascc.org.

(* Denotes Required Fields)

Session Dates
April 12, 19, 26 and May 3, 10, 17
Please provide the following information.
Your Name: *
Address: *
City, State and Zip Code: *
Phone Number: *
Email: *
Date of Birth: *
Last four of social security: *
Additional Information - required
I live alone or with someone other than a spouse and MY monthly income is approximately:
My Monthly Income:
I live with my spouse and OUR monthly income is about:
Our monthly income:
Please tell us about the care recipient.
Name: *
Address: *
City, State and Zip: *
Phone Number:
Email:
Date of Birth: *
Last four of social security:
Relationship to Caregiver: *
Primary Medical Condition: *
Additional Information - required
Lives alone or with someone other than a spouse and MY monthly income is approximately:
My Monthly Income:
Lives with spouse and OUR monthly income is about:
Our Monthly Income: