2025 Senior Retreat Registration Form

Please complete the following registration form to attend the 2025 Senior Retreat, sponsored by the National Federation of the Blind Seniors Division, being held anywhere and everywhere February 16-22, 2025. The registration fee is $50 per attendee. The deadline to register and submit payment is February 7, 2025 at 11:59pm Eastern.

Please complete one form per attendee. After completing the form, please click on the PayPal button found on the form's confirmation page to complete your payment transaction via PayPal by using a credit card, debit card, or PayPal account.

If you prefer submitting payment via check, please make checks payable to NFB Seniors Division with "2025 Senior Retreat" in the memo field and send to:
NFB Senior Division
c/o Duncan Larsen
304 East Simpson Street
Lafayette, CO 80026-2326

If you prefer to make an instant payment using Zelle, you may do so by choosing to send money and adding NFB Senior Division as a recipient. When asked whether you want to add a mobile number or email address to send, choose mobile and use 979-583-6343 as the number for the recipient.

All required fields are marked with a *.

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Prefered Phone Number *

Email

How will you enter the Zoom platform? *

How will you be listed on the call? *

Name

Phone number (identify number)

Other

How will you be listed on the call? Other

Registration Fee *

Senior Retreat Registration ($50 per person)

Payment Method *

Check or Money Order

Zelle

PayPal or Credit/Debit Card

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