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Event or Presentation Request Form

* Mission

With an overarching mission to eliminate ageism and ensure the dignity and quality of life of approximately 1.8 million older New Yorkers, the NYC Department for the Aging is deeply committed to helping older adults age in their homes and creating a community-care approach that reflects a model age-inclusive city.

* Event and presentation requests will be prioritized in accordance with NYC Aging’s mission and population served.

All requests are required to be submitted at minimum 14 days in advance.

* Indicates required fields

Event Name *

Requester First Name*

Requester Last Name*

Organization Name*

Organization ZIP Code*

Phone(e.g. XXX-XXX-XXXX)*

Email *

Event Date*

Event Time*

Event Borough*

Event Address/Location *

Event ZIP/Postal Code*

Type of Request *

Expected Number of Attendees *

Target Audience (Older Adults 60+, Professionals, Caregivers, Agencies, etc.) *

Event Topic *

Describe the Event or Presentation Requested *

Will you need materials in other languages? *

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