SubscribeemailTwitterFacebookPinterestLinkedinGoogle+ * Means that information is requiredWe only need your Last Name and Email address. All other information is OPTIONAL. Please note: bulletins can not be delivered to addresses such as 'firstname.lastname@example.org', 'email@example.com', 'firstname.lastname@example.org' etc. First NameLast Name*Email* Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country PhoneAbout YouWe truly appreciate your taking the time to answer the following questions. This information will help us meet your information needs in the future and with the development of AIPatHome.com. Gender Female Male Ageunder 4950-5556-6061-6566-7071-7576-8081-8586-9091-9596-100100+How did you learn of AIPatHome.com?Are you interested in aging in place for:MyselfLoved OneBoth myself and loved one(s).Is your interest primarily as:ConsumerAIP ProfessionalBoth Consumer & ProfessionalAre you a caregiver?Yes - ProfessionalYes - Not ProfessionalNoAREAS OF INTERESTWhat kinds of resources and information are you interested in receiving from AIPatHome.com? (Please check all that interest you.)Universal Design New Homes Remodeling/Incorporating UD features into my current home Products/Appliances Locating a Certified Aging in Place Specialist (CAPS) DIGITAL HEALTH/TELECARE How to use technology for caregiving Learn about products Caregiving from a distance Smart/Connected Homes How to make my home a Smart or Connected Home Products Service Providers FOR AGE IN PLACE PROFESSIONALSAIP ProIf you are an AIP professional, briefly describe what you do/industry.Special training, certifications or memberships - please check all that apply: AIA: American Institute of Architects ASID: American Society of Interior Designers AOTSS CAASH: Certified Active Adult Specialist in Housing CAPS: Certified Age in Place Specialist CBD: Certified Bathroom Designer CCP CEAC: Certified Environmental Accessibility Consultant CGP: Certified Green Professional CGR: Certified Graduate Remodeler Certified Long Term Care Ombudsman CKD: Certified Kitchen Designer CRTS: Certified Relocation Transition Specialist CSP Executive Certificate in Home Modifications, USC MBC NAIPC: Nat'l Aging in Place Council OT: Occupational Therapist PT: Physical Therapist RE: Realtor SRES:Senior RE Specialist UDCP: Universal Design Certified Pro (NARI) Other memberships:AIP Business Pages I want to get listed in the AIP Business Pages - send me info! AND FINALLY,Comments/Questions4+6 =*This is to make sure you're human and not a spam bot!