Skip to content
Make a Contribution
A
Decrease font size.
A
Reset font size.
A
Increase font size.
Join Newsletter
Login
or
Create an Account
HOME
ABOUT THIS PORTAL
Project Background
Frequently Asked Questions
How To Use
LOCATIONS
FIND A PROGRAM
AROUND TOWN DC EVENTS
View All Events
Ongoing Virtual Fitness Classes
Ongoing Virtual Arts Classes
Virtual Special Events
CONTACT US
Create an Account
Mykal L
2021-01-21T12:38:07-05:00
Create a Free Account so you can register for any of our great events!
This form is used to collect information required by the DC Department of Aging and Community Living (DACL). Collecting this information is a condition of our DACL grant which provides funding for this program.
DC residents aged 60+ are eligible to create an account.
If you have any questions about this form, please contact Around Town DC at community@iona.org
First Name
*
Middle Name or Initial
Last Name
*
Street Address:
*
Suite/Apt
Zip Code
*
Select Ward
*
1
2
3
4
5
6
7
8
Phone Number
*
Home
Mobile
Work
Date of Birth
*
E-mail Address
*
Password
*
Confirm Password
*
Password must contain at least 8 characters.
Permission to add email to Around Town DC and Iona newsletters:
*
Yes
No
Benefits Receiving
*
Commodity Supplemental Food/Farmers Market
Food Stamps/SNAP
Medicaid--Elderly and Persons with Disabilities Waiver
Medicaid--Intellectual and Developmental Disabilities
Medicaid--State Plan
Medicare
Public Assistance
Qualified Medicare Beneficiary (QMB)
Social Security (SSA)
Social Security Disability Income (SSDI)
Supplemental Security Income (SSI)
Veteran's Benefits
Other
None
Are you a member of a village? If so, which one?
The following questions ask for basic demographics information required by DACL. Please check all that apply and note that
Refused
is an option.
Gender Identity
*
Male
Female
Transgender
Other
Race
*
African American
American Indian
Asian
Native Hawaiian or other Pacific Islander
White
Other
Refused
Ethnicity
*
Hispanic or Latino
Not Hispanic or Latino
Refused
Primary Language Spoken
*
English
Spanish
Vietnamese
Korean
Chinese
French
Amharic
American Sign Language (ASL)
Other
Disability
*
Physical
Mental
Physical and Mental
None
Refused
Number in Household (Optional)
Approximate Monthly Income (Optional)
Only fill in if you are not human
IMPORTANT NOTICE:
[
SITE MAINTENANCE
]. Some classes may not appear on the calendar.