First Name
Last Name
Email Address
Phone Number  ( ) Ext:
Mailing Address
Street Address
Address 2 (optional):
City or Town
State
Zip or Postal Code
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I would like to receive informative brochures for:

1. Myself
2. My parent(s)
3. A loved one

I would like information regarding the process for moving into a Baptist Retirement Community:

1. Baptist Inn Retirement Center Community
2. Clairmont Crest Retirement Apartments
3. Garrison Personal Care, Assisted Living

I would like to have a representative from Baptist Retirement Communities speak with me or my senior adult Sunday school, or civic group regarding:

1. Retirement Living, making the best choice
2. Estate Planning
3. Gaining a better understanding of Medicare/Medicaid
4. Health issues for senior adults
5. Dealing with Alzheimer’s
6. Taxes-how to pay less
7. Managing resources for best results
8. Preparing a Christian will

I would like to become a partner with Baptist Retirement Communities and support this ministry in the following manner:

1. One time gift
2. Monthly donations
3. Establishing a trust fund
4. Naming Baptist Retirement Communities in my will