Please fill out the form below if you plan to attend.

Dutchess County’s Collaboration of Services and Care Across the Life Span
 
November 30, 2018

If you need to cancel your reservation/attendance, it is appreciated if you could please  notify Damara Tolasssi at dtolassi@dutchessny.gov

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* 1. First Name

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* 2. Last Name

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* 3. Title

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* 4. Agency Address

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* 5. Email Address

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* 6. Telephone Number

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* 7. Do you require a Sign Language interpreter? (Seven days notice is required to secure this service).

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* 8. Box lunch will be served at the event - please indicate your preference

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