COMMUNITY COLLEGES OF BALTIMORE COUNTY - …



THE COMMUNITY COLLEGE OF BALTIMORE COUNTY (CCBC)

STATE OF MARYLAND PRE-RETIREMENT PLANNING SEMINARS SPRING 2008

(For Members of Participating Boards of Education, County and Local Governmental Units)

Members within 8 years of retirement and their spouses are eligible to attend the following one-day seminars which begin at 8:30 a.m. and end at 4:00 p.m. A letter of confirmation will be sent no later than seven business days prior to your scheduled date.

Please place “1” (first choice) and “2” (second choice) next to the seminar you wish to attend.

|JA__ |March 1 (Saturday) |JF__ |April 19 (Saturday) |JL__ |May 16 (Friday) |

| |CCBC, Catonsville Campus | |CCBC, Essex Campus | |CCBC, Owings Mills Center |

| |Catonsville, MD | |Essex, MD | |Owings Mills, MD |

| | | | | | |

|JB__ |March 7 (Friday) |JG__ |April 21 (Monday) |JM__ |May 19 (Monday) |

| |CCBC, Owings Mills Center | |Salisbury University | |Western MD Hospital Center |

| |Owings Mills, MD | |Salisbury, MD | |Hagerstown, MD |

| | | | | | |

|JC__ |March 14 (Friday) | JH__ |April 22 (Tuesday) |JN__ |May 29 (Thursday) |

| |Prince George’s Community College | |Frederick Community College | |CCBC, Essex Campus |

| |Largo, MD | |Frederick, MD | |Essex, MD |

| | | | | | |

|IF__ |March 17 (Monday) |JI__ |April 28 (Monday) | JO__ |June 13 (Friday) |

| |Department of Agriculture | |College of Southern MD | |Eastern Shore Hospital Center |

| |Annapolis, MD | |La Plata, MD | |Cambridge, MD |

| |(LEOPS Only) | | | | |

| | | | | | |

|JD__ |April 1 (Tuesday) |JJ__ |May 8 (Thursday) | JP __ |June 17 (Tuesday) |

| |Allegany College | |Harford Community College | |Prince George’s Community College |

| |Cumberland, MD | |Bel Air, MD | |Largo, MD |

| | | | | | |

|JE__ |April 14 (Monday) |JK__ |May 13 (Tuesday) | JQ __ |June 18 (Wednesday) |

| |Department of Agriculture | |Montgomery College | |CCBC, Hunt Valley Center |

| |Annapolis, MD | |Rockville, MD | |Hunt Valley, MD |

| | | | | | |

| | | | | | |

| | | | | | |

SEE REVERSE SIDE FOR REGISTRATION INFORMATION

STATE OF MARYLAND PRE-RETIREMENT PLANNING

(For Members of Participating Boards of Education, County and Local Governmental Units)

REGISTRATION FORM – SPRING 2008

Please print all information:

NAME_____________________________________________________________________________________________________

Last First Middle Initial

ADDRESS__________________________________________________________________________________________________

Number and Street City State Zip Code

EMPLOYER________________________________________________________________________________________________

WORK PHONE ________________________________________ SOCIAL SECURITY #_________________________________

(OPTIONAL)

HOME PHONE________________________________ EMAIL ADDRESS _________________________________________

DATE OF

BIRTH _________________ (REQUIRED) _____Male ____Female

Mo. Day Yr.

Please indicate any special assistance required for a handicapped condition.___________________

________________________________________________________________________________

| |

|Will spouse attend? Yes________ No_________ If Yes, please complete the following information: |

| |

|____________________________________________________________________________________________________ |

|Last name First Middle |

|Initial |

Employee’s Signature_________________________________________ Date________________

(Required) (I authorize CCBC to release this information to the State of Maryland.)

MAIL COMPLETED FORM TO:

(Please be sure to fill out and submit both sides of form)

The Community College of Baltimore County (CCBC)

Pre-Retirement Planning Registration, L129

7201 Rossville Boulevard

Baltimore, MD 21237

OR FAX TO:

Fax Number: 410-780-6856

Attention: Sarah Cullip

For information call: 410-780-6632

-----------------------

For Office Use Only:

Course # MAN 969_______

Date: __________________

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