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PS 2018
Information & Guide Request
Letter from the Publisher
Tell us a bit more about your needs so we may offer the best resources to help
you . Please complete only the amount of information you feel comfortable
sharing . We will follow up with you by phone or email (whichever you prefer) .

name

e-mail address: day phone number:

address: city, state, zip:

Inquiring for: self friend relative

If other than you, what is the name and age of person needing assistance:
first name: age:

Desired location for the housing, service(s) or product(s) to be provided:

I would like extra copies of the guide sent to me .

Puget Sound Portland/Vancouver
Mid-Willamette Valley Southern Oregon

When you’ve completed the form, please cut out this page, place in a stamped
envelope and mail to:

Attn: Help & Information
Retirement Connection Guide
PO Box 820067
✂ Portland, OR 97282

You may also fax the form to: 503-334-2868

Or you may contact us online at:
www .RetirementConnection .com