Clermont Senior Serices, Inc.

                 

 

 

 

 

 

 

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HIPAA Privacy Notice

HIPAA MS Word Document

 

Current Job Openings

IF YOU SIGNED UP AT AN EARLIER DATE OR SOMEONE ELSE SIGNED YOU UP AND YOU ARE WANTING TO MAKE PAYMENT ONLY, PLEASE CLICK ON THIS LINK:  Paypal Online.   Otherwise follow the instructions below.  Thanks.

 

There are two ways to Register for the Golf Outing.  (Choose only one)

  1. Call Connie at our office at 513-536-4021 and she will register your foursome.

  2. Online By Credit Card -- Fill out the form below and click on the Submit button.

If you ARE NOT part of a foursome fill out Name #1 and Phone # only.

 

Names of your Foursome:

[FrontPage Save Results Component]
Name #1:   Put name of person paying here.
Phone #:   Put phone # of person paying here.
Name #2:
Name #3:
Name #4:

Would you like to be a SPONSOR?  Please fill out the form below and click on the Submit button.

[FrontPage Save Results Component]
Sponsor Name:
Contact Person:
Contact Phone #:
Type of Sponsorship:

Our main funders:           
Send mail to gshivener@clermontseniors.com with questions or comments about this web site.
Copyright © 2003 Clermont Senior Services, Inc.
Last modified: 06/09/08