THE COMMUNITY COLLEGE OF BALTIMORE COUNTY (CCBC)

STATE OF MARYLAND PRE-RETIREMENT PLANNING SEMINARS FALL 2012

(For Members of Participating Boards of Education, County and Local Governmental Units)

Members within 8 years of retirement and their spouses are eligible to attend the following one-day seminars which begin at 8:30 a.m. and end at 4:00 p.m. A letter of confirmation will be sent no later than seven business days prior to your scheduled date.

Please place “1” (first choice) and “2” (second choice) next to the seminar you wish to attend.

GA __ / September 13 (Thursday)
Harford Community College
Bel Air, MD / GF __ / October 12 (Friday)
Department of Agriculture
Annapolis, MD / GK __ / November 5 (Monday)
Hagerstown Community College
Hagerstown, MD
GB __ / September 20 (Thursday)
CCBC, Catonsville Campus
Catonsville, MD / GG __ / October 15 (Monday)
CCBC, Essex Campus
Essex, MD / GL __ / November 14 (Wednesday)
CCBC, Catonsville Campus
Catonsville, MD
GC __ / September 26 (Wednesday)
Prince George’s Co. RMS Building
Largo, MD / GH __ / October 17 (Wednesday)
Mt. Saint Mary’s University
Frederick, MD / GM __ / November 19 (Monday)
Salisbury University
Salisbury, MD
GD __ / September 28 (Friday)
Worcester County Government
Snow Hill, MD / GI __ / October 18 (Thursday)
Howard Community College
Columbia, MD / GN __ / December 6 (Thursday)
Harford Community College
Bel Air, MD
GE __ / October 5 (Friday)
CCBC, Owings Mills Center
Owings Mills, MD / GJ __ / October 26 (Friday)
Towson University
Towson, MD / GO __ / December 10 (Monday)
Montgomery College
Rockville, MD
LE __ / October 10 (Wednesday)
Eastern Shore Hospital Center
Cambridge, MD
(Law Enforcement Officers Only) / LP __ / November 2 (Friday)
CCBC, Essex Campus
Essex, MD
(Law Enforcement Officers Only)

For information call: 443-840-1632

Or email:

SEE OTHER PAGE TO FILL OUT REGISTRATION FORM


STATE OF MARYLAND PRE-RETIREMENT PLANNING

(For Members of Participating Boards of Education, County and Local Governmental Units)

REGISTRATION FORM – FALL 2012

For information call: 443-840-1632 or email:

Please print all information:

NAME______

Last Suffix First Middle Initial

ADDRESS______

Number and Street City State Zip Code

EMPLOYER______DATE OF BIRTH ______

County/City Agency (REQUIRED) Month Day Year

WORK PHONE ______HOME PHONE______

EMAIL ADDRESS ______LAST 4 DIGITS OF SOCIAL SECURITY #______

ARE YOU A STATE EMPLOYEE?  Yes  No

ARE YOU A MEMBER OF THE LAW ENFORCEMENT OFFICER PENSION SYSTEM?  Yes  No

ARE YOU ELIGIBLE TO RETIRE WITHIN 8 YEARS?  Yes  No

Employee’s Signature______Date______

(Required) (I authorize CCBC to release this information to the State of Maryland)

Will spouse attend? Yes______No______If Yes, please complete the following information:
______
Last name First Middle Initial

Please indicate any special assistance required for a handicapped condition.______

______

SUBMIT YOUR COMPLETED FORM:

EMAIL: (must email a signed copy)

OR

FAX: 443-840-1856 or 410-780-6856 (Attention Sarah Cullip)

OR

MAIL TO: The Community College of Baltimore County (CCBC)

Pre-Retirement Planning Registration, L129

7201 Rossville Boulevard

Baltimore, MD 21237