THE COMMUNITY COLLEGE OF BALTIMORE COUNTY (CCBC)

STATE OF PRE-RETIREMENT PLANNING SEMINARS SPRING 2014 (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.

PC __ March 12 (Wednesday) PG__ April 8 (Tuesday) PM __ May 14 (Wednesday) Harford Community College Allegany College Bel Air, MD Columbia, MD Cumberland, MD

PA __ March 13 (Thursday) PH __ April 10 (Thursday) PN__ May 16 (Friday) CCBC, Catonsville Campus CCBC, Catonsville Campus Catonsville, MD Catonsville, MD Towson, MD

PB __ March 20 (Thursday) PI __ April 17 (Thursday) PS__ May 20 (Tuesday) Department of Agriculture State Highway Administration Mt. Saint Mary’s University Annapolis, MD Hunt Valley, MD Frederick, MD

PD __ March 28 (Friday) PJ __ April 24 (Thursday) PO__ May 22 (Thursday) Mt. Saint Mary’s University Chesapeake College Prince George’s Co. RMS Bldg. Frederick, MD Wye Mills, MD Largo, MD

PE __ April 1 (Tuesday) LP __ April 28 (Monday) PP __ June 3 (Tuesday) Harford Community College College of Southern MD Salisbury, MD Bel Air, MD La Plata, MD (Law Enforcement Only) PF__ April 4 (Friday) PK __ April 29 (Tuesday) PQ __ June 4 (Wednesday) Hagerstown Community College CCBC, Essex Campus Eastern Shore Hospital Center Hagerstown, MD Essex, MD Cambridge, MD

PL __ May 9 (Friday) PR__ June 5 (Thursday) CCBC, Owings Mills Center CCBC, Essex Campus Owings Mills, MD Essex, MD

For information call: 443-840-1632 Or email: [email protected]

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 – SPRING 2014 For information call: 443-840-1632 or email: [email protected]

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: [email protected] (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) For Office Use Only: Pre-Retirement Planning Registration, L129 Course # MAN 969______7201 Rossville Boulevard Date: ______Baltimore, MD 21237