Form Center

2. If you have a question about programs or services available through the Senior Resource Center (SRC), please use the form on this page to contact SRC staff. After submitting the form, your question will be directed to the appropriate SRC staff member who will respond to your inquiry. Please, no marketing or sales attempts through this format.

   If you prefer not to use the contact form, please call 910-798-6400 to speak with a staff member.

   Please note: most SRC programs and services are available for older adults ages 55+, however certain grant-funded programs (for example, nutrition and transportation) may only be available for seniors ages 60+ due to grant restrictions. If you are not sure if you qualify for a program, please reach out to SRC staff. We are happy to help you connect to a variety of community resources for older adults.

4. First and Last Name*
5. Phone Number*
7. Email Address
8. I prefer to be contacted by:*

   1. Phone
   2. Email
10. I have a question about:*

    1. Activities & Events at the SRC
    2. Caregiver Support
    3. Exercise & Physical Fitness at the SRC
    4. Home Delivered Meals
    5. In-home Aide Services
    6. Life Enrichment Program (LEP) - Independence and Quality of Life
    7. Medicare/Seniors Health Insurance Information Program (SHIIP)

    1. Lunch or Nutrition Counseling at the SRC
    2. Saving money on prescriptions
    3. Transportation to medical appointments or the SRC
    4. Volunteering - Foster Grandparents or Retired & Senior Volunteer Program (RSVP)
    5. Volunteering - Home Delivered Meals
    6. Other/General Question
12. Please enter your question, then click the submit button to send your question to the Senior Resource Center*
Leave This Blank:


14. 1. Receive an email copy of this form.
15. Email address

    This field is not part of the form submission.

16. Submit

* indicates a required field