Do you want you elder check mailed?
If your response is no, you do not need to fill out the rest of the form or submit
If you are filling out the form on behalf of an elder, please fill out their name
What district are you in?
Will you still attend the elder dinner event?
If yes, will you bring a caregiver?
Which location will you attend?

Elders who reside in zip codes listed below and choose to have their check mailed but still plan to attend the Elder Dinner must attend the 

Carnegie Elder Dinner: 73015, 73062, 73507, 73651, 73038, 73005, 73006

This is the name of the person filling out the form on behalf on an elder
Which best describes your relationship to the elder
(Enrollment will reach out to verify)
Accepted forms of legal ID, such as tribal ID, passport, state ID, and driver’s license, must be photo ID
One file only.
100 MB limit.
Allowed types: jpg png pdf.