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Group name Group address Telephone County Number of members Type of group AARP Chapter Adult Day Care Advisory Committee Allied Council Alzheimer's Chapter Area Agency on Aging CAP Agency Church/Synagogue Citizens Advocate City Aging Office County Aging Office Foster Grandparents Hospital Senior Group NARFE Wisconsin Chapt WREA Chapt Nutrition Site Professional Retirees RSVP Group Senior Center Service Group Service Provider Statewide Association Support Group Senior Housing Group Union/Retired Union Veteran's Group Other Is your group statewide? Yes No Because all CWAG information will be mailed to your group representative, it is necessary to notify CWAG (at the address below) of any changes. For information on member group responsibilities, click here. Representative name Rep. address Rep. telephone President/director other contact person for this group Pres./contact telephone Please select a sponsorship level ... $25/year basic membership $50/year contributing membership $100/year sustaining membership $200/year supporting membership $ Additional contribution to support CWAG's grass-roots fund raising $ Total Click "send" to submit your application electronically. You will be billed for your membership fee and your donation, if applicable. Or ... print the form, fill it out by hand and "snail" mail it to CWAG. Top of form
Group name
Group address
Telephone
County
Number of members
Type of group AARP Chapter Adult Day Care Advisory Committee Allied Council Alzheimer's Chapter Area Agency on Aging CAP Agency Church/Synagogue Citizens Advocate City Aging Office County Aging Office Foster Grandparents Hospital Senior Group NARFE Wisconsin Chapt WREA Chapt Nutrition Site Professional Retirees RSVP Group Senior Center Service Group Service Provider Statewide Association Support Group Senior Housing Group Union/Retired Union Veteran's Group Other
Is your group statewide?
Yes No
Because all CWAG information will be mailed to your group representative, it is necessary to notify CWAG (at the address below) of any changes. For information on member group responsibilities, click here.
Representative name
Rep. address
Rep. telephone
President/director other contact person for this group
Pres./contact telephone
Please select a sponsorship level ...
$25/year basic membership $50/year contributing membership $100/year sustaining membership $200/year supporting membership
$ Additional contribution to support CWAG's grass-roots fund raising
$ Total
Click "send" to submit your application electronically. You will be billed for your membership fee and your donation, if applicable.
Or ... print the form, fill it out by hand and "snail" mail it to CWAG.
Top of form
