One form must be completed for each individual attendee, even if you are registering at the team rate.
Indicates required field
First Name:
Last Name:
First Name or Nick Name for Badge:
Title Category:
Organization Type:
If other:
Phone: Example: xxx-xxx-xxxx
Cell: Example: xxx-xxx-xxxx
Fax: Example: xxx-xxx-xxxx
Additional Emails for Confirmation:
Organization Affiliation: Non-Profit For-Profit Government
Other (Please specify)
I heard about the conference from: Pioneer Network Website Internet search Advertisement
Colleague Email Brochure Social Media
State Coalition
Another conference (Please specify)
Other (Please specify)
Number of Annual Pioneer 
Conferences attended:
0   1   2   3   4   5 or more
Is this the first time your organization has attended a Pioneer Network Conference? Yes No
Special Dietary Needs:
Special Assistance Needs:
  Please check here if you do not give Pioneer Network permission to publish your name and contact information.
Pioneer Network is offering a "TEAM" discounted registration fee. "TEAM" is defined as 4 or more attendees registering from the same organization. Those receiving other discounts do not qualify toward your team numbers. If you are unsure of the attendees’ names at this moment, please register as TBD. Should you have any questions regarding your "TEAM" registration, please email our registrar at

Registration Type

Team / Individual
6/1 and after
on site
Full Conference Registration (8/4 - 8/7) Individual
Full Conference Registration (8/4 - 8/7) Team
(4 or more people from same organization. Fee is per person)
Full Conference Resident Registration (8/4 - 8/7) Resident (Person living in a
senior living community)
2-Day Registration (any 2 days)
Indicate which days attending:
Monday Tuesday Wednesday
1-Day Registration (any 1 day)
Indicate which day attending:
Monday Tuesday
Additional Exhibitor (requires registration code - enter below first) Individual

Please mark your selected registration fee.

Registration Code
If you have received a registration code, please enter your code here. SISTERS, please enter the code you were provided here. The appropriate price will appear below.

There is a $35 fee for each license application made. Even if you are licensed in 3 states, the fee for that license will remain $35. Please select the license type, provide license number(s) and state(s) below. Please note these will be emailed to you within 2 weeks of the conference completion.


License #(s)

Social Workers
Activities Professionals
Registered Dietitians
Certificate of Attendance    
In order to assure that you have the best experience possible, we are asking if you would please indicate which concurrent session you are most likely to attend, understanding that you can change your mind!
Session A - Monday August 5, 2019 11:15 AM - 12:45 PM (Click here for Concurrent Session Details)
Workforce Culture: What it is and Why it Matters
Quality Dementia Care - Best Practices and Quality  
Organizational Change: One Neighborhood at a Time
Addressing Ageism Through Intergenerational Art Programming with People Living with Dementia
Award-Winning Neuroscience Approach for Dementia Residents in Memory Care
Translating our Professional Experiences of Death into Meaningful Service to Elders
Preventing Harm for Nursing Home Residents While Honoring Choice
Overcoming Obstacles in Creating the Household Model
Can Residents Activate Culture Change: You Bet! Here's How
Thrive Center Session: Learn About Thrive Center (session limited to 50 people)  
Session B - Monday August 5, 2019 2:30 PM - 4:00 PM (Click here for Concurrent Session Details)
Workforce Culture: What Employees Want You to Know
A Theory Driven Framework to Engage Staff in Resident-Centered Care  
Cultural Competencies & Diversity Planning: A Pathway Promoting a New culture of Aging
Creating a More Liveable Community for All: How They Did it in Burlington, VT!
Harnessing Music's Full Value in Healthcare - A New Gold Standard
Age Queer: The Workshop
The Role of POLST in Advanced Care Planning: Supporting Choice at End of Life
Rethinking the Building, Rebuilding the Thinking - Elders in Distress
The Spirit of Sustainability in Person-Centered Care…and How Important It Is!
Thrive Center Session: Virtual Reality Supporting Individuals with Dementia To Live their Best Lives (session limited to 50 people)  
SAGE Conversation: The Deep Seated Issue of Choice
Session C - Tuesday, August 6, 2019 8:00 AM - 9:30 AM (Click here for Concurrent Session Details)
Workplace Culture: Creating an Inclusive Community
Dementia Care in Rehab: Research Supported Concepts, Tools and Approaches  
Transformational Kindness: Mastering Emotional Intelligence to Practice the Golden Rule
Deinstitutionalizing Eldercare Through the Wisdom of Community-Centered Living
Did You Know, I Can Say No!!
Cultivating a Culture of Compassionate Care
Transforming Care Through Age-Friendly Health Systems
Mattering Really Counts - Measuring Quality of Interactions
Initiating Aha Moments! It's all in a Strong Foundation
Thrive Center Session: Using Compassionate Touch® to Build CarePartner Relationships (session limited to 36 people)  
Living Out Loud with Dementia  
Session D - Tuesday August 6, 2019 10:15 AM - 11:45 AM (Click here for Concurrent Session Details)
Retention 911: Hiring, Inspiring, Engaging, Retaining
Living Well With Dementia: Expert Panel  
Making it Happen: Lessons in Change Management
Chief Engagement Officers: Why It's Time to Hire a New "CEO"
We Imported Fresh Dining Culture: Our Resident Directed Culture Journey Accelerated
Breaking Down the Boundaries
Providing Trauma Informed Care: A Path to Control and Empowerment for Elders
Creating a "No Bullying" Community: Practical Training, Recommendations and Programs
SAGE Session: Mentor as a Noun and a Verb
Thrive Center Session: Learn About Thrive Center (session limited to 50 people)  
Session E - Tuesday August 6, 2019 1:15 PM - 2:45 PM (Click here for Concurrent Session Details)
Leading the Workforce through the Lens of Love
Breaking Down Old Bathing Culture in Dementia Care Settings: New Designs, New Programs, and New Success!  
Focus on Strengths! Building a Strengths-Based Culture in Your Home
The Jill's House Story: A Relationship-Based Intergenerational Community…Making it Happen!
Pan to Plate: Bringing True Culinary Experiences into Resident Spaces
Stress Management for the Caregiver
Adding Mental Health First Aid to Your Person-Centered Skillset
Respite for All: A Friend Revolution
Out of the Box and Ahead of the Curve
Thrive Center Session: Beyond Bingo: Why Silent Disco Are the Next Big Thing (session limited to 50 people)  
Wednesday August 7, 2019 - 8:00 AM - 1:45 PM (Click here for Intensive Session Details)
Person-Centered Palliative Care: Be the Bridge
Ageism: Exploring the Connection to Who We Are and the Work We Do
Loving: The Essence of Being a Butterfly in Dementia Care
Build your own Full Day Intensive
Wednesday August 7, 2019 - AM Mini-Intensives 8:00 am - 10:45 pm (2.5 hours with 15 min break)(Click here for Intensive Session Details)
Doing Better Together: Huddling for High Performance
Engagement and Connection for All - the Circle Talk Way
Lessons Learned from Implementing an Evidenced-based, Person-centered Communication Tool
Rethinking Dementia: A Well-Being Approach
Montessori Applications to Dementia Care: So Much More than Just Activities
Wednesday August 7, 2019 - PM Mini-Intensives 11:15 am - 2:00 pm (2.5 hrs with 15 min break)(Click here for Intensive Session Details)
Eat Status Quo for Breakfast: Be a Courageous Leader
A Transformation to Neighborhoods: Construction, Organizational Design, Change & Technology
Person Centered Practices: Returning Power to Those We Support
Unlocking and Desegregating Memory Care: Practical Pathways to Inclusion
Wednesday August 7, 2019 8:00 am - 2:00 pm (5-hour session) (Click here for Site Visit Details)
Businar Tour to The Homeplace of Midway, Kentucky (limit 40 people)
Nazareth Home (limit 60 people)
In order to assist us in planning space and meals, please let us know what you plan to attend below.
Sunday, August 4 12:00 pm - 4:30 pm Ombudsman Surveyor Session: Recognizing a Shared Vision – Building and Maintaining Collaborative Working Relationships for Lasting Culture Change (Providers, residents and family members welcome)
Sunday, August 4 2:00 p.m. – 4:15 p.m. Dementia Care Special Session: Implementing the Alzheimer’s Association Dementia Care Practice Recommendations Across the Continuum of Care
Sunday, August 4 5:00 pm - 6:30 pm Welcome: Exploring How to "Make it Happen!"
Roll Call of States/Provinces/Nations
Sunday, August 4 6:30 pm - ? Put Your Oxygen Mask on First: Discover Louisville Walk
Monday, August 5 8:00 am - 10:30 am Breakfast and General Session: Nurturing the Spirit — A Key to Making it Happen!
Monday, August 5 12:45 pm - 2:30 pm Lunch Break / Exhibitor/Sponsor Gallery Open / Box Lunch
Monday, August 5 1:00 pm - 2:00 pm Special Session for Families and Residents
Monday, August 5 4:00 pm - 6:00 pm Networking Reception with Exhibitors and Sponsors: Putting the FUN in Relationships
Tuesday, August 6 6:30 a.m. – 7:30 a.m. Put Your Oxygen Mask on First: Explore the River Walk
Tuesday, August 6 11:45 am - 1:15 pm Lunch Break / Exhibitor/Sponsor Gallery Open / Box Lunch
Tuesday, August 6 3:15 pm - 5:00 pm General Session: The Voice of Elders — Our Guides on the Journey
Contribute to the work of Pioneer Network and the culture change movement. Your gifts are tax deductible, and all of them, large and small, are deeply appreciated.
Donation Amount:
There are a limited number of scholarships available. Anyone wishing to apply should send a request for application to
Total Due:
Please check one: Visa
American Express
Check - Send payment to Pioneer Network
                                              c/o OPTimum Planning
                                              424 General Early Drive
                                              Harpers Ferry, WV 25425
Name of Cardholder:
Card Number:
Expiration Date: (mmyy - ex: 0719)
Security Code:
Card Billing Address:
By submitting this form, I am authorizing The Pioneer Network to process my credit card for payment as indicated above. If paying by check, I acknowledge that payment must be received within 45 days of invoice. If registration is part of a team discounted registration, I agree that any change which results in my organization dropping below the minimum for team requirement will result in rest of the registrations being charged the normal registration fees. I acknowledge responsibility for those changes. Conference badges and conference materials will be distributed on-site; nothing will be mailed. All cancellations must be submitted in writing and must be received by June 15, 2019 to be eligible for a refund, less a $50 administrative/cancellation fee. No requests for refunds will be accepted after June 15, 2019. Attendee substitutions may be made at any time, without penalty. To submit cancellation and/or substitution requests - email to, fax to 304.566.9911 or mail to Pioneer Network, c/o OPTimum Planning, 424 General Early Drive, Harpers Ferry, WV 25425.
Pioneer Network