First Name

Last Name

When did you begin participating in the senior housing and care industry? 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960

Company

Type of Company None Developer Financial Intermediary Healthcare Provider/Payer Investor/Equity Provider Lender/Debt Provider Product/Service Provider Senior Housing & Care Provider (Operator) Transactional Services

Focus Area (Click and hold Ctrl or Cmd key to multi-select) Active Adult AgeTech Assisted Living Capital for Operations Capital for Real Estate Continuing Care Retirement Community (CCRC)/Life Plan Community Independent Living Memory Care Middle Market Skilled Nursing Value Based Healthcare Relationships Other

Title

Role C-level (CEO, CFO, CIO, Founder, President, EVP) VP (Senior Vice President, Vice President) Managing Director Director Manager Other

Email

Mobile Phone

Gender: How do you identify? Female Male Non-binary Prefer not to answer I use other term

What is your ethnicity? Hispanic or Latino Not Hispanic Prefer not to answer

What is your race? (Click and hold Ctrl or Cmd key to multi-select) American Indian or Alaska Native East or Southeast Asian South Asian Asian Black or African American Native Hawaiian or Other Pacific Islander Middle Eastern/North African (MENA) White Other race Prefer not to answer

Volunteer Interest (Click and hold Ctrl or Cmd key to multi-select) Board of Directors Operator Advisory Board (OAB) Active Adult Committee AgeTech Committee Capital for Operations Committee Middle Market Committee Partnering for Health Committee Conference Program Committees Future Leaders Council Advisory Committee Research Committee Diversity, Equity, & Inclusion (DEI) Committee NIC Academy Advisory Board NIC Academy Instructor Thought Leadership Content Contributor Conference Session Speaker AdHoc Task Force

LinkedIn Profile (Copy link from Public profile & URL section of your profile)

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