Workshop Registration First Name* Last Name* Email Address* Enter Email Confirm Email Phone Number*Zip Code How did you hear about us?*How did you hear about us?PostcardCompanyGoogleReferralOtherWhen are you eligible for Medicare (birth month)?*When are you eligible for Medicare (birth month)?JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDates*- Select a Workshop -Tuesday, October 10th – 6:00pm (Edina)Thursday, October 26th – 6:00pm (Maplewood)PhoneThis field is for validation purposes and should be left unchanged. Δ