Hudson Senior Center Registration

Welcome!

So that we may better serve you, we ask that all seniors who actively partake of the programming offered by Hudson Senior Services provide us with the following information.

General participation is $10 per year. (checks made payable to: Town of Hudson)

Please complete this form and click the submit button at the bottom of the page.

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Date

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First Name *

Last Name *

Gender *

Street Address *

City *

State *

Zip Code *

Phone Number *

E-mail Address: *

Date of Birth

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Vial of Life *

Given Form

Turned In

What motivated you to come in today?

Activities and Programs you want to participate in:

Is there a second person at the same address to participate? If yes, fill out information below.

Yes

Full Name of Second Member

E-mail Address of Second Member

Second Member Gender

Second Member Date of Birth

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Second Member Vial of Life

Given Form

Turned In

Hudson Senior Center Registration

Welcome!

Contact Information