Elder Abuse Prevention Roundtable Registration Form

Enter phone number (i.e. 207-123-4567)
The Roundtable will include an interactive and dynamic conversation about responding to elder abuse situations and the Maine resources available to assist attendees in addressing elder abuse issues at the local level. A shared resource table will be available at this year's Roundtable, so we invite you to bring resources about the services provided by your organization.

If you have any special needs or dietary requirements, please enter them below.

Payment of $25 per attendee must be provided by check only made payable to "Legal Services for the Elderly." Checks may be mailed in advance of the event. Mail your check, along with the registrant's name and organization to: Legal Services for the Elderly, Attn: Roundtable Organizer, 5 Wabon Street, Augusta, ME 04330. **Please Note: We cannot accept cash payment for this event**