Membership Application
We look forward to you joining Senior Provider Group of Anne Arundel County!
Business/Organization Name
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Number
Website
Business/Organization Representative
*
First Name
Last Name
Email
*
example@example.com
Additional Representative
First Name
Last Name
Email
example@example.com
Type of Business
*
Please Select
Anne Arundel Dept. of Aging and Disabilities
Active Adult Community
Adult Day Care
Advocacy
Assisted Living
Assistive Telephones
Attorneys
Bereavement Services
Case Management
Cemeteries/Memorial Programs
Complaints & Information
Congregate Housing
Consumer Credit
Dental Services
Disability Services
Discounts
Discrimination
Education
Elder Abuse
Emergency Information
Emergency Response
Employment and Job Counseling
End of Life Planning & Celebrations
Estate Sale Services
Exercise/Activities
Eye Care
Financial Services and Programs
Food and Nutrition
Funeral Homes
Health Organizations
Hearing Services
Home-Based Primary Care
Home Care, Concierge Care Services
Home Care, non medical
Home Health Care
Home Improvement/Repairs
Hospitals
Hospice Services
Housecleaning
Housing Services
Income Assistance
Information and Assistance
Insurance Services
LGBT Resources
Library Services
Loan Closets
Lunch Sites
Media and Marketing
Mediation
Medical Products and Services
Medicare/Medicaid
Memory Care
Mental Health Services
Movement Disorders
Moving/Relocation Services
Nursing Care Facilities
Parks and Recreation
Pet Care Services
Pharmacy Services
Physicians
Podiatry Services
Real Estate Services
Referral and Planning Services
Rehabilitation/Physical Therapy
Respite Care
Retirement Community
Senior Centers
Subsidized Housing
Support Groups
Tax Information and Assistance
Telecommunications
Temporary Shelter/Housing
Transporation
Veterans Services
Victim and Witness ASsistance
Vital Records
Volunteer Opportunities
Voting
Please select the category in which your organization should be listed in the directory,
Membership Type
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1 Year Membership
Includes (1) listing in Senior Resource Book
$
125.00
Partial year Membership
(July 1-Dec 31)
$
60.00
Billing & Next Steps
You can either mail your check to PO Box 130, Severna Park, MD 21146 or via PayPal (add $3.04 to total). We will send you an invoice and direct link to pay online. Please click here to sign up for email alerts/reminders: http://eepurl.com/hpcxFT
Apply for Membership
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