The Colorado Medicare Plan for You!

First Name *

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Last Name *

NOTE: RMHP provides Medicare insurance exclusively in Colorado.

Colorado County - select - Adams Alamosa Arapahoe Archuleta Baca Bent Boulder Broomfield Chaffee Cheyenne Clear Creek Conejos Costilla Crowley Custer Delta Denver Dolores Douglas Eagle El Paso Elbert Fremont Garfield Gilpin Grand Gunnison Hinsdale Huerfano Jackson Jefferson Kiowa Kit Carson La Plata Lake Larimer Las Animas Lincoln Logan Mesa Mineral Moffat Montezuma Montrose Morgan Otero Ouray Park Phillips Pitkin Prowers Pueblo Rio Blanco Rio Grande Routt Saguache San Juan San Miguel Sedgwick Summit Teller Washington Weld Yuma

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Mailing Address

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City

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State -- AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

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Zip Code

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Email Address

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Phone No. * ( ) -

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Choose Meeting Time(s) and Location(s)

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• Thursday, 4/19/2012, Loveland, 10:00 a.m.
• Thursday, 4/19/2012, Loveland, 2:00 p.m.
• Tues, 4/24/12, Greenwood Village, 10:00 a.m.
• Tuesday, 5/1/2012, Cortez, 9:00 a.m.
• Thursday, 5/1/2010, Cortez, 1:00 p.m.
• Thursday, 5/24/12, Grand Junction, 2:00 p.m.
• Tuesday, 6/5/12, Greenwood Village, 10:00 a.m.
• Wednesday, 6/6/12, Boulder, 2:00 p.m.
• Tuesday, 6/12/12, Ft. Collins, 2:00 p.m..
• Wed, 6/13/12, Colorado Springs, 2:00 p.m.
• Thursday, 6/14/12, Pueblo, 2:00 p.m.
• Tuesday, 9/11/2012, Boulder, 2:00 p.m.
• Wed, 9/12/12, Colorado Springs, 2:00 p.m.
• Thurs, 9/13/12, Greenwood Village, 2:00 p.m.
• Tuesday, 9/18/12, Grand Junction, 10:00 a.m.
• Thursday, 9/20/12, Ft. Collins, 2:00 p.m.

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Remember to print out the Sales Seminar Schedule for exact meeting location information.

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Number Attending

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Special
Accommodations

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