7
2017 PASC Conference Registration Form Prism of Possibilities Name: ________________________________________________________________________ Center or Agency Name: ___________________________________________________ _______________________________________________________________________________ Address: ____________________________________________________________________ _______________________________________________________________________________ City/Town:__________________________________________________________________ Zip Code: ________________ County: _______________________________________ Phone Number: ____________________________________________________________ Email Address: _____________________________________________________________ Region: (circle) Central Northeast Northwest Southeast Southwest Conference Information: ____ I am a first time attendee to the PASC Conference ____ I am renewing my membership from last year ____ I am staying for lunch Friday, Oct. 6th ____ I need vegetarian lunches Dates Attending: ____ Wednesday, Oct. 4th - Pre-Conference ____ Thursday, Oct. 5th ____ Friday, Oct. 6th Please indicate what breakout session you will be attending: Friday, October 6th (10:30-12:00) ____ Protective Services Explained ____ SAGE ____ Hypno-Breathing to Reduce Stress Payment Information Remittance: Member Fees: Member Pre-Conference Fee $125 ___________ Member One Day Conference Fee $135 ___________ Member Two Day Conference Fee $185 ___________ Non-Member Fees: Non-Member Pre-Conference Fee $125 ___________ Non-Member One Day Fee $185 ___________ Non-Member Two Day Fee $235 ___________ Group Discount is 10% if 3+ attendees: ___________ Total Due for Conference Registration: ___________ *(If you would like to be billed for your attendance at the Conference, please email Bobbi Manges to make those arrangements. She will need an authorization signature from your Fiscal Office. Bill later options are only available from Agencies. No individuals will be billed later.) Optional Thursday Evening Activities (See attached form.) Mt. Nittany Vineyard & Winery Tour and Tasting (4:14-6:15) - $25 _________ Sip & Paint + 1 Complimentary Drink Ticket (7:00-9:00) - $25 _________ ** Or you can opt to do both activities at a total cost of $40!!! _________ * Please make a Separate Check for these activities payable to PASC PASC Memberships MUST be submitted separately from the Conference Registration. (See attached form.) * Make checks payable to PASC Renewing Membership: $40 New Membership: $60 Please make checks payable to PASC for the Conference Payment Send payment and registration form to: Bobbi Manges C/O: Bedford Office on Aging PO Box 46 Bedford, PA 15522 REGISTRATION DEADLINE is September 15, 2017

2017 PASC Conference Registration Form Payment Information ... · 2017 PASC Conference Registration Form ... Hypno-Breathing to Reduce Stress: Presented by: Shannon Keyes Ciucevich

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Page 1: 2017 PASC Conference Registration Form Payment Information ... · 2017 PASC Conference Registration Form ... Hypno-Breathing to Reduce Stress: Presented by: Shannon Keyes Ciucevich

2017 PASC Conference Registration Form

Prism of Possibilities

Name: ________________________________________________________________________

Center or Agency Name: ___________________________________________________

_______________________________________________________________________________

Address: ____________________________________________________________________

_______________________________________________________________________________

City/Town:__________________________________________________________________

Zip Code: ________________ County: _______________________________________

Phone Number: ____________________________________________________________

Email Address: _____________________________________________________________

Region: (circle) Central Northeast Northwest Southeast Southwest

Conference Information: ____ I am a first time attendee to the PASC Conference ____ I am renewing my membership from last year ____ I am staying for lunch Friday, Oct. 6th ____ I need vegetarian lunches Dates Attending: ____ Wednesday, Oct. 4th - Pre-Conference ____ Thursday, Oct. 5th ____ Friday, Oct. 6th Please indicate what breakout session you will be attending: Friday, October 6th (10:30-12:00) ____ Protective Services Explained ____ SAGE ____ Hypno-Breathing to Reduce Stress

Payment Information

Remittance: Member Fees: Member Pre-Conference Fee $125 ___________ Member One Day Conference Fee $135 ___________ Member Two Day Conference Fee $185 ___________ Non-Member Fees: Non-Member Pre-Conference Fee $125 ___________ Non-Member One Day Fee $185 ___________ Non-Member Two Day Fee $235 ___________ Group Discount is 10% if 3+ attendees: ___________ Total Due for Conference Registration: ___________ *(If you would like to be billed for your attendance at the Conference, please email Bobbi Manges to make those arrangements. She will need an authorization signature from your Fiscal Office. Bill later options are only available from Agencies. No individuals will be billed later.) Optional Thursday Evening Activities (See attached form.) Mt. Nittany Vineyard & Winery Tour and Tasting (4:14-6:15) - $25 _________ Sip & Paint + 1 Complimentary Drink Ticket (7:00-9:00) - $25 _________ ** Or you can opt to do both activities at a total cost of $40!!! _________ * Please make a Separate Check for these activities payable to PASC PASC Memberships MUST be submitted separately from the Conference Registration. (See attached form.) * Make checks payable to PASC Renewing Membership: $40 New Membership: $60 Please make checks payable to PASC for the Conference Payment Send payment and registration form to: Bobbi Manges C/O: Bedford Office on Aging PO Box 46 Bedford, PA 15522

REGISTRATION DEADLINE is September 15, 2017

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Pennsylvania Association

of Senior Centers

Annual Conference 2017

The Nittany Lion Inn State College, PA

Pre-Conference Workshop: Wednesday, October 4 Conference: Thursday, October 5 &

Friday, October 6, 2017

PA Senior Centers:

Prism of Possibilities

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Welcome

The board of PASC would like to welcome you

to the Annual PA Association of Senior

Centers (PASC) Conference. Once again we

are calling the beautiful Nittany Lion Inn our

home away from home as we share

“Prism of Possibilities”

We hope this theme will get you thinking about

all the possibilities within your center’s

operation and programming. In addition we

hope that you will discover or re-discover and

be re-energized with the passion for your job,

and your Senior Center.

We would like to welcome you to Happy Valley.

Take some time to enjoy your surroundings,

the conference and networking opportunities.

Conference Contact Information C/O: Bobbi Manges

Huntingdon-Bedford-Fulton AAA

240 Wood Street

PO Box 46

Bedford, PA 15522

Registration Questions:

Please call Bobbi at 814.623.8148

Pre-Conference Fee $125 Member

$125 Non-Member

Conference Fee For 2-Days $185 PASC Member $235 Non-member

Conference Fees for 1 Day $135 PASC Member $185 Non-member

Includes: 2 day conference, 2 breakfasts, 2 lunches, 2

great keynotes, choice of 3 breakout sessions, conference materials, door prizes, and

networking opportunities! Two Thursday evening activities are available for an additional charge.

Conference At- A- Glance:

Prism of Possibilities

Wednesday October 4

9:00-5:30: Pre-Conference: PDA Health and Wellness Approved Evidence Based Training:

SAIL: Stay Active and Independent for Life

Thursday October 5

8:30-9:00: Conference Registration:

Continental Breakfast

9:00-9:15: Welcome

9:15-10:45 Keynote Session:

The Inspirational Leader and The Power of Purpose:

Joe Mull

10:30-10:45: Break

10:45-12:00: Regional Meetings:

Central Region

Northeast Region

Northwest Region

Southeast Region

Southwest Region

12:00-1:30: Award Luncheon with Sec. Osborne

1:30-2:30: General Session:

Should You Start a Music Therapy Program in Your

Center?: Jessica Mull

2:30-2:45: Break

2:45-4:00: General Session:

Service Dogs, Therapy Dogs and Support Dogs:

What is the difference?: Nancy Dreschel

4:15-6:15: Winery Tour: includes transportation to

winery, the tour and sampling: $25 per person

7:00-9:00: Sip and Paint: includes painting class,

one complimentary drink ticket: Cash Bar available;

$25 per person

**** Can do both activities for $40 ****

Friday October 6 8:00-8:45: PASC Breakfast/Annual Meeting/

Roy Afflerbach

8:45-9:00: Time to check out

9:00-10:30: General Session:

Creative Aging in PA: Panel and Demonstration

10:30-12:00: Breakout Sessions

Protective Services Explained: Lori Heaton

SAGE: Martha Slagy

Hypno-Breathing to Reduce Stress: Shannon

Keyes Ciucevich

12:15-2:15 Closing Speaker and Luncheon:

Maintaining Passion For Your Job: Lori Gravish

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Wednesday, October 4

9:00 a.m. –5:30 p.m. Pre-Conference Workshop: SAIL: Stay Active and Independent for Life:

Evidence Based Program: Presented by: Miss Demby

This is a Pennsylvania approved Evidence Based Program: Stay Active and Independent for Life (SAIL) is a

strength, balance and fitness program for adults 65 and older. Performing exercises that improve strength,

balance and fitness are the single most important activity that adults can do to stay active and reduce their

chance of falling. The entire curriculum of activities in the SAIL program can help improve strength and

balance, if done regularly. SAIL is offered 3 times a week in a one hour class. SAIL exercises can be done

standing or sitting. After participating in this workshop, you will be able to implement and instruct the SAIL

classes at your center. Participants will receive a certificate from this program and the materials to lead

the program.

Thursday, October 5

8:30-9:00: Registration and Breakfast

9:00–9:15: Welcome

9:15-10:45: Keynote: THE INSPIRATIONAL LEADER AND THE POWER OF PURPOSE: Presented

by Joe Mull: Every day care professionals go to work and make astounding differences in the lives of

others. Unfortunately the never-ending challenges and changes we face in care environments can disconnect

us from seeing our own impact. Using humor and stories, this program helps attendees create line of sight

between the tasks and responsibilities of their job and the real-world impact they have. Interactive,

inspiring, and uplifting, this program will leave attendees energized about their work while equipping them

with tactics to inspire their own teams after the conference.

10:30-10:45: Break

10:45-12:00: Regional Meetings

12:00-1:30: PASC Awards Luncheon with Sec. Theresa Osborne

1:30-2:30: Group Session: Should You Start a Music Therapy Program in Your Center?

Presented by: Jessica Mull The clinical and evidence-based use of music therapy with seniors has been

shown to be an effective way to address anxiety, depression, isolation, withdrawl, agitation or fear common

among seniors. Music therapy can also be used to promote independence, self-expression, and physical and

psycho-social health and well-being among this population. As of July 1, 2017 the PA Department of Human

Services added Music Therapy as a reimbursable service to the Home and Community-Based Services

Waiver. In this session, Board Certified Music Therapist Jessica Mull, who specializes in senior care, helps

attendees interested in exploring this new funding opportunity understand what constitutes music therapy,

who is qualified to deliver MT services and how music therapy differs from other music-related activities.

2:30-2:45: Break

2:45-4:00: General Session: Service Dogs, Therapy Dogs, Support Dogs: What is the Difference?

Presented by: Nancy Dreschel Nancy will talk about the differences between the types of dogs, and

share how the process works for training and working with dogs, including the “dos and don’ts“ of

approaching a trained dog.

OPTIONAL EVENING ACTIVITIES

(See Separate Registration For These Activities with Complete Details.)

4:15-6:15: Winery Tour and Tasting: those signed up will meet in the lobby at 4:15 to

depart for Mt. Nittany Vineyard and Winery.

7:00-9:00: Sip and Paint Party for those who are pre-registered, it will be held at The

Nittany Lion Inn in Ballroom ABC.

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Friday, October 6

8:00-8:45: Annual Meeting and Legislative Update from Roy Afflerbach.

The annual business meeting of PASC will be held including election of board members and introduction of

new officers, nominations for openings from the floor. Roy will give an update on current state business.

8:45-9:00: Time to check out

9:00-10:30: Creative Aging in PA: Panel and Demonstration: Presented by: Gayle Cluck, Jess

Campbell, Jef Savage, Nancy Walker, Jaime Dunlap: This session will review how the PA Department of

Aging collaborated with PA Council on the Arts (PCA) to help senior centers increase center participation

and broaden community engagement through artist residencies. Residency design and implementation is

planned by the local PCA Arts in Education partner, senior center staff, and professional teaching

artists. One residency model will be featured. Bring your dancin’ shoes!

10:30-12:00: Breakout Sessions: (Choose one of 3)

Protective Services: Presented by Lori Heaton: In this session, you will learn about the various types

of abuse to older adults and examples will be shared with you. You will learn how to recognize signs of

abuse and what you can do when you suspect that a consumer is being abused.

SAGE: How to Create a More Welcoming Agency in the LGBTQ Community: Presented by Martha

Slagy

Hypno-Breathing to Reduce Stress: Presented by: Shannon Keyes Ciucevich Come learn some simple and

powerful techniques of self-hypnosis and breath work that could help stress roll right off your back! Of

course, you can keep doing what you have been doing and you will keep getting the same results OR you

could have fun learning to incorporate these simple techniques into you daily life to release stress and

tension. What do you have to lose… except stress?

12:15-2:15: Closing Luncheon: Maintaining Passion for Your Job: Presented by: Lori Gravish Lori will

once again share her wealth of knowledge on maintaining passion for your job.

Basket Drawings

Evaluations

The Pennsylvania Association of Senior Centers (PASC) is a statewide, professional, non-profit organization dedicated to the enhancement of Senior Centers for the benefit of older adults. The organization was started more than two decades ago by a group of visionaries who recognized the importance of properly staffed and organized

senior centers across the Commonwealth. Their vision extended into areas important to the successful operations of senior centers and to the communities that support them.

PASC has set for itself the mission to:

Provide professional training towards the enhancement of Senior Centers.

Promote communication with policy makers in the Commonwealth.

Educate the public about the crucial role of Senior Centers.

Work cooperatively with the Pennsylvania Department of Aging and Long Term Living, and Pennsylvania Association of Area Agencies on Aging (P4A)

Offer ideas and information for improving the operations of Senior Centers

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Registration Information

Registration Fees Received by September 20 Members* : Pre-Conference: $125, Two Day Conference: $185, One Day Conference: $135 Non-Members: Pre-Conference: $125, Two Day Conference: $235, One Day Conference: $185

Group Discounts PASC makes excellent, cost-effective staff training even more accessible by offering special discounts for groups. PASC organizational members take 10% off registration fees for 3 or more individuals attending from the same organization/center.

Cancellations and Refunds A 15% cancellation fee will be charged for all cancellation requests received in writing no later than October 1. There will be no refunds after that date. Payment must be received before the Conference begins or you must be prepared to pay on-site for an additional charge. Attendance will not be permitted if payment is not received.

Conference Attire Dress for the conference is casual and relaxed for all sessions and meals. NOTE: Because room temperatures may vary, you may want to bring a light sweater or jacket.

Membership Dues $60 new or lapsed membership, $40 renewing from previous year

Hotel Information The Nittany Lion Inn 200 West Park Avenue, State College, PA 16803 1-800-233-7505 Room Rates: $130 per night + 8.5% occupancy tax Rooms for the conference can be booked online at www.http://www.pshs.psu.edu/NittanLionInn/ or be booked directly through

The Nittany Lion Inn. The room reservation code (which can be used online or over the phone) is PAAJ17B. The Nittany

Lion Inn is a non-smoking facility. Hotel rates are subject to applicable state and local taxes. Please ask the hotel about their tax-exempt policy upon making your reservation. Rooms will be held until September 15, 2017.

Please remember to dress appropriately for the

rooms as the temperature many vary depending

on the location. Bring a sweater if necessary!

Regional Baskets will be raffled off during

the event. The drawing for the winning

tickets will be held on Friday at the

conclusion of the luncheon.

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Thursday Evening, October 5, 2017 – (Optional) Paint The Town Red Activities!

Vineyard Tour and Wine Tasting - October 5, 2017 (4:20-6:15 PM)

Mt. Nittany Vineyard & Winery tour and tasting on October 5, 2017, from

4:30 PM-6:00 PM. The transport van will leave promptly at 4:20 PM from

outside the front entrance of the hotel in order to allow for enough time to

maximize your experience. Space is limited, early registration is encouraged.

Mt. Nittany Vineyard & Winery is an authentic family farm winery

producing exceptional wine since 1990 from our 65-acre mountainside

location - just minutes from State College. They take great pride in providing their guests with a

fun and informative wine-tasting experience while they enjoy the ambiance of their beautiful

setting. They will begin with an introduction to their six-acre vineyard, followed by a tour of their

winemaking facility with winemaker, Scott Hilliker. You will then be ushered into their private

Vintner’s Loft where you will have the opportunity to taste from a selection of 26 wines that are

bottled on the premises. A logo keepsake wine glass is yours to take home after the tasting.

Following your tasting, there will be plenty of time to socialize on the covered deck overlooking the

pond and to do some shopping at their tasting room gift shop.

Sip & Paint - October 5, 2017 (7:00-9:00 PM)

You will take home a 12 x 12 painting that you create entitled

"Sunset on a Mountain Lake". Our instructors for the class will be

Marti and Nelson Leader. This project will be a relaxing activity and

a fundraising idea that you can take back to your Senior Center.

Wear comfortable clothing and/or a "paint shirt" in case you are

messy! Each participant will receive a complimentary drink ticket

and a Cash Bar will be available for additional drinks. This activity

will take place in the Ballroom ABC of the Nittany Lion Inn.

-----------------------------------------------------------------------------------------------------------------

Name: ________________________________________________________________________

Address: _______________________________________________________________________

Phone Number: _________________________________________________________________

Check Which Activity You Would Like to Do: Winery Only ($25.00): ____ Sip & Paint Only ($25.00):____ Winery & Sip & Paint ($40.00) ____

* Submit a separate check and this Registration Slip per person payable to "PASC" for these

activities. Please enclose with your Conference Registration to Bobbi Manges. *