THE COMMUNITY COLLEGE OF BALTIMORE COUNTY (CCBC) STATE OF MARYLAND PRE-RETIREMENT PLANNING SEMINARS SPRING 2015 (For State Agency/State University Employees Only) State employees 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. SA __ February 20 (Friday) CCBC, Essex Campus Essex, MD SJ __ March 26 (Thursday) Hagerstown Community College Hagerstown, MD ST __ May 7 (Thursday) CCBC, Catonsville Campus Catonsville, MD SB __ February 24 (Tuesday) 300 W. Preston Street Baltimore, MD SK__ April 2 (Thursday) 300 W. Preston Street Baltimore, MD SU__ May 11 (Monday) Department of Agriculture Annapolis, MD SC __ February 26 (Thursday) Department of Agriculture Annapolis, MD SL__ April 7 (Tuesday) College of Southern MD La Plata, MD CR__ May 12 (Tuesday) Hagerstown Community College Hagerstown, MD (Correctional Officers Only) SD __ March 4 (Wednesday) Howard Community College Columbia, MD SM__ April 8 (Wednesday) State Highway Administration Hunt Valley, MD SV __ May 15 (Friday) Towson University Towson, MD SE __ March 10 (Tuesday) Salisbury University Salisbury, MD SN__ April 14 (Tuesday) Frostburg State University Frostburg, MD LO __ May 18 (Monday) Harford Community College Bel Air, MD (Law Enforcement - LEOPS Only) SF __ March 13 (Friday) Towson University Towson, MD SO__ April 16 (Thursday) CCBC, Catonsville Campus Catonsville, MD SW __ May 28 (Thursday) MD School for the Deaf Columbia, MD ASL Provided SG __ March 17 (Tuesday) MDOT Headquarters Hanover, MD SP__ April 21 (Tuesday) Mt. Saint Mary’s University Frederick, MD SX__ May 29 (Friday) CCBC, Essex Campus Essex, MD SH __ March 18 (Wednesday) CCBC, Owings Mills Center Owings Mills, MD SQ__ April 28 (Tuesday) MAIF Headquarters Annapolis, MD SY__ June 3 (Wednesday) 300 W. Preston Street Baltimore, MD SI __ March 19 (Thursday) Harford Community College Bel Air, MD SR__ April 29 (Wednesday) SZ__ University of MD University College Largo, MD SS__ May 5 (Tuesday) Eastern Shore Hospital Center Cambridge, MD June 9 (Tuesday) CCBC, Owings Mills Center Owings Mills, MD For information call: 443-840-1632 Or email: scullip@ccbcmd.edu SEE OTHER PAGE TO FILL OUT REGISTRATION FORM STATE OF MARYLAND PRE-RETIREMENT PLANNING (For State Agency/State University Employees Only) REGISTRATION FORM – SPRING 2015 For information call: 443-840-1632 or email: scullip@ccbcmd.edu NAME_____________________________________________________________________________________________________ Last Suffix First Middle Initial ADDRESS__________________________________________________________________________________________________ Number and Street City State Zip Code EMPLOYER_____________________________________________ State Agency DATE OF BIRTH __________________________ (REQUIRED) Month Day Year WORK PHONE ________________________________________ HOME PHONE__________________________________ EMAIL ADDRESS______________________________ COUNTY OF RESIDENCE _________________________ ⁮ □Yes ⁮□No ARE YOU A STATE EMPLOYEE? ARE YOU A MEMBER OF ANY OF THE FOLLOWING PENSION SYSTEMS? □ Correctional Will spouse attend? □Yes □ No □ Law Enforcement (LEOPS) □ State Police If Yes, please complete the following information: Spouse’s First name:__________________________ Spouse’s Last Name: ________________________ Employee’s Signature_________________________________________ Date________________ (Required) (I authorize CCBC to release this information to the State of Maryland) Please indicate any special assistance required for a handicapped condition.___________________________ ________________________________________________________________________________ Are you of Hispanic or Latino origin? □ Yes ⁮□ No What is your race? Select one or more of the following categories: □White □Black or African American □Asian □American Indian or Alaska Native □Native Hawaiian or Other Pacific Islander SUBMIT YOUR COMPLETED FORM: EMAIL: scullip@ccbcmd.edu (must email a signed copy) OR FAX: 443-840-1856 (Attention Sarah Cullip) OR http://www.ccbcmd.edu/ceed/preretirementstate/ OR ONLINE: MAIL TO: The Community College of Baltimore County (CCBC) For Office Use Only: Pre-Retirement Planning Registration, BESS 116 Course # MAN 969_______ 7201 Rossville Boulevard Date: __________________ Baltimore, MD 21237