Future Centenarian Registry:
Do you know someone 90 to 99 years
old?
Our Future Centenarian Network is a
national registry database of 90 to 99 year olds. Please fill out
the form below and tell us about your future centenarian.
Privacy Policy: Signing up a
centenarian is completely safe. Names in the national registry are
kept confidential, unless specific permission is given by the
centenarian and/or family member on a case by case basis, in order
to protect the identity of participants from unwanted solicitation
or contacts.
Contact Lynn Peters Adler, J.D. Adler@NCAP100s.org
Register by phone: 1-800-243-1889Register by USPS mail:
Or simply fill out the following form
All information given to the
National Centenarian
Awareness Project
is kept strictly confidential.
Items marked with an * are required
*Your name
*Email
*Name of 90 to 99 year old
*Birthdate of 90 to 99 year old
*Address of 90 to 99 year old
*Relationship (son, daughter, grandson, friend,
neighbor, etc...)
*Your telephone number
Your address
City, State, Country, Zip Code
Comments or additional information about your future centenarian
To submit the form,
please enter the "Submit Code" that
follows
Submit Code:
Please enter the Submit
Code:(case sensitive)
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