Become a Hearing Partner | Colorado Gerontological Society

Why become a hearing partner?

-Trusted name in aging for over 35 years
-CGS receives 800+ hearing service requests annually
-Hearing brochures are directly mailed into the hands and homes of seniors and their families
-Your partnership supports CGS and our efforts to provide hearing services to needy seniors

Click here to download the PDF form or below to request your listing online.

Hearing Brochure Partner

Fill the form to request your space as a hearing partner

Step 1 of 3

Request a listing to become a hearing partner
All listings are valid for 12 months.
Contact Name*
First Last
Name of Organization*
Contact Email*
Contact Phone*
Contact Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

- Same as contact name?
Name for listing
First Last
- Same as previous?
Name of Organization for listing
Address for listing
Same as Contact Address?

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
- Same as Contact Phone?
Phone for listing
Website for listing

Product Name
All listings are valid for 12 months.
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Billing Address
Same as Contact Address?

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Subscribe to CGS Event Mailing List?
- Subscribe to receive email updates of upcoming events and trainings?