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2. Contact Name*
3. Email Address*
5. Business/Group Name*
7. Phone Number*
8. Website
10. Event Description*
12. Requested Event Date and Time

    Give up to three date and time options. 

13. Option 1*
    Option 1 Start Date

    Option 1 Start Time

    —

    Option 1 End Date

    Option 1 End Time
14. Option 2*
    Option 2 Start Date

    Option 2 Start Time

    —

    Option 2 End Date

    Option 2 End Time
15. Option 3
    Option 3 Start Date

    Option 3 Start Time

    —

    Option 3 End Date

    Option 3 End Time
17. SELECT TOPIC(S) FROM THE CATEGORIES BELOW:
19. Aging in Community (Orange County Staff)

    1. Aging in Place
    2. Cognitive Change
    3. Dementia Friendly Orange County
    4. Falls Prevention
    5. Home Safety
    6. Mental Health 101
    7. Transportation Basics – Navigating Orange County
    8. Welcome to Medicare!
20. Caregiver Series (Orange County Staff)

    1. Caregiving 101
    2. Caregiving During the Holidays
    3. Caregiver Self-Care
    4. How to Have a Social Visit With Someone With Dementia
    5. Long Distance Caregiving
    6. What is Respite?
22. End of Life Presentations and Workshops (Orange County Staff and Partners)

    1. 12 Funeral Myths
    2. Advance Directives
    3. Beyond the Edge: Alternative Body Disposition Practices
    4. Bringing the Dead To Life: The Art of the Obituary
    5. Funeral Art with Mini-Coffins!
    6. General Price Lists Demystified
    7. Good Grief: The Art of Writing a Condolence Letter
    8. Home Sweet Home Funerals
    9. Hospice 101
    10. The Case for Green Burial
    11. Voluntary Stopping Eating and Drinking (VSED)

24. For additional information or questions, please contact the Aging Helpline call 919-968-2087 or email agingtransitions@orangecountync.gov. We look forward to speaking at your event. Thank you!

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