Do You need more guides AND Would you like to be included on the new online interactive map?
Sign in to Google to save your progress. Learn more
We have added a new feature on our website for seniors and their families looking for copies of the guide, an interactive map that shows the locations of where guides can be found in their area. This will allow those looking for guides to find them at a location nearest to them, and will also allow you to be known to them as a resource in their community! Please complete the form below if you would like to be added to the map, and if you are in need of more guides at your location.  
Here is the map link https://retirementconnection.com/books/
What is your Company Name? *
Company Address (Street, City, State, Zip) *
Guide Market *
Do you currently have guides in stock at your location? If so, how many?
Are you in need of more guides? *
How many guides do you need? For Portland and Puget Sound, 1 box is roughly 30 guides. For Mid-Willamette Valley and Southern Oregon, 1 box is roughly 50 guides.
Clear selection
Point of Contact Email (this will be used for internal communication with our staff) *
Point of Contact Phone *
Would you like this phone number to be listed on the interactive map for seniors and their families to contact you with any questions? *
Preferred Method of Communication (with our staff) *
Do you have any other specific pick-up instructions you would like seniors or their families to know for your location? 
(i.e. Guides can be found in our lobby, Guides can be found on the 2nd floor at reception desk, etc.)
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Retirementconnection.com. Report Abuse