The Colorado Commission on Aging is proud to sponsor the Centenarian Project for all seniors 100 years or older. The Centenarian project is an annual and ongoing event of the Colorado Commission on Aging intended to celebrate the lives of Centenarians across the state, recognize their individual century of achievement, and focus the attention of all Coloradans on the political and social issues of aging. The Project recognizes seniors who have achieved the age of 100 or older by awarding Centenarian Certificates, prepared by the Commission, and signed by the Governor of Colorado. For more information please contact Tara Franck at:
[email protected] or at: 303-866-5288 To request a Centenarian Certificate please fill out the form below and return. To receive a Centenarian Certificate please type or print legibly and remit this form (see below).
Name: ____________________DOB:_____________Place of Birth:______________________________ Current Residence: ____________________________________ City: ________________ Zip: ______ Address to send Certificate to if different than above: ______________________________________________________ City: _____________Zip: ________ Card Completed by:_____________________Phone #______________Email:____________________ Relationship to Centenarian:________________________________________ ____________________ I would like to have a Commissioner present the Certificate:
YES
NO
Address, name of building (if any), date of party, and time:______________________________________ ____________________________________________________________________________________ Please remit information to: ATTN: Centenarian Project-Colorado Commission on Aging 1575 Sherman Street, 10th Floor, Denver, CO 80203 303.866.2696 FAX or via email to:
[email protected]
