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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.
Demographics
The following questions ask for basic demographics information required by DACL. Please check all that apply and note that Refused is an option.
Photo Release
Do you give Iona Senior Services permission to use my photographic image in promotional materials to include (but not limited to): publications, video, and website images.
Show Liability Waiver