SAGE NYC - SAGE Centers - Programming Proposal Form

Thank you for your interest in working with SAGE (Services and Advocacy for GLBT Elders)! As the nation's oldest and largest organization dedicated to improving the lives of LGBT older adults, SAGE is committed to providing our participants with the highest quality programming. Our goal is to ensure that all adults are able to age actively and healthfully in their own communities.

First Name*	Last Name*


Organization Name (if applicable)


Street Address	Line Two


City	State	Zip


Email*	Phone*


Please briefly describe the program you propose leading at SAGE* Are you interested in providing this program on a voluntary basis?* Yes No What is the goal of the program as it relates to SAGE's mission of healthy, active aging in community? What can our participants gain from attending this program?* What are your qualifications or credentials for producing this program?* SAGE is an organization that works with Gay, Lesbian, Bisexual and Transgender elders. What experience, if any, do you have working with the community that SAGE caters to?* What is your ideal start date?* What is the frequency of the program?* One-time event Series/recurring (how many times/for how long?) Are there any special materials or physical space accommodations needed to produce the program?* In which site(s) can you offer this program? Choose as many as are applicable.* Bronx (260 E188th Street) Brooklyn (25 Flatbush Avenue) Harlem (127 W127th Street) Midtown (305 7th Avenue) Staten Island (25 Victory Boulevard) Please upload your resumé.* (Word or PDF only please.)

*Required field

Contact SAGE National

SAGE
305 Seventh Ave, 15th Floor
New York, NY 10001
212-741-2247 tel
212-366-1947 fax
info@sageusa.org
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