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Hebron Community Calendar

December 2022

Sun Mon Tue Wed Thu Fri Sat
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  • St. Peter's Chu…
  • Hebron Holiday Celeb…
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  • Food Share Van - Red…
  • Zoning Board of Appe…
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  • Housing Authority
  • Douglas Library Boar…
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  • Planning & Zonin…
  • WPCA Meeting
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  • Reg 8 Insurance Cons…
  • Board of Finance
  • Board of Selectmen
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  • Elementary Schools R…
  • Public Building Comm…
  • RHAM Board of Educat…
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  • Food Share Van - Red…
  • Chatham Health Distr…
  • School Readiness Cou…
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  • Holiday - Town Offic…
  • Republican Town Comm…
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  • Holiday - Town Offic…
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Upcoming Events

Tips for Completion of the Russell Mercier Senior Center Registration Form

Tips for Completion of Form 5- Consumer Registration Form
I. SAMS Details- Personal
f. SSN- This form requests the last four digits of your Social Security
number only; if you wish, you may choose to enter four zeroes
g. Default Agency- Enter NCAAA (North Central Area Agency on
Aging)
IV. Assessment Form- Demographics (continued)
d. Income- You may choose to check “Unknown”
Please be sure to sign the Form 5- Consumer Registration Form, where indicated.
Supplement to Form 5- Consumer Registration form:
Medical Conditions: If none, please check “None”
Allergies: If none, please check “None”
This information is collected for reporting to our current and future funding
sources and is useful for the Senior Center to have, especially during an
emergency.