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Meaningful Connections Order Form:

Please complete the information below, check the appropriate box, and press the Submit button. (NOTE: Please do not use all uppercase characters for your entries.)

Last Name:   Example: Smith
First Name:   Example: Adam
Title:   Example: OBRA Coordinator
Organization:   Example: Community Mental Health
Address:   Example: 100 Grand Ave
City:   Example: Lansing
State:   Example: MI
Zip:   Example: 48901
County:   Example: Ingham
Phone:   Example: 517/222-3333
Email:   Example:
DVD and CD only.
Manual with DVD & CD.

Mental Health and Aging Project at Lansing Community College

Mental Health & Aging Project
Phone: (517) 483-1529
Additional contact information »