Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Age Friendly Portland On-line Application

  1. Note

    Age Friendly Image

  2. Please fill in

    If you are interested in being designated as an Age Friendly Business or Organization,
    please review and complete this on-line form.

    Age Friendly Portland
    P.O. Box 3413, Portland, ME 04104
    T: 207-541-6620 F: 207-541-6623

    Email: AgeFriendlyCommunity@PortlandMaine.gov

  3. Please indicate if you are a Business or Organization:

  4. To Qualify:

    • Must be a business or organization located in or providing services in Portland, Maine. Designation criteria is outlined on the next page of this application.

  5. The Process:

    • After completing and returning this form and the following pages, you will be contacted by a representative of the Age Friendly Portland Steering Committee.


    • The representative will schedule a mutually convenient time to visit your business to see some of your Age Friendly qualities in action.


    • A panel will review your application and information gathered at the visit.


    • If approved, you will receive an Age Friendly Portland decal to formally esignate your business or organization as being Age Friendly. You will also receive an electronic version of the logo.


    • Your business or organization will be listed and receive promotion on the Age Friendly Portland website and Facebook page.

  6. Please indicate if you have multiple locations you’d like designated:

  7. Age Friendly Portland Logo

  8. Age Friendly 2

  9. Exterior Enironment

    Minimum of 5

  10. Interior Environment

    Minimum of 5

  11. Age Friendly Portland Logo

  12. facebook

  13. Customer Service / Employee Training

    Minimum of 4

  14. Marketing Suggestions

    Minimum of 2

  15. What is ADA?

    The Age Friendly Business guidelines are not the same as the Americans with Disabilities Act (ADA), although Age

    Friendly Business and ADA share many of the same goals to improve access for everyone. Becoming an Age Friendly

    Business does not absolve a business from obligations under the civil rights law of the ADA. A more detailed ADA

    checklist for existing businesses is available for free at www.adachecklist.org. Businesses that would like to learn

    more about the ADA a guide is available at https://www.ada.gov/regs2010/smallbusiness/smallbusprimer2010.htm.


    TAX INCENTIVES are available to encourage compliance with the Americans with Disabilities Act.

    http://adata.org/factsheet/quicktips-tax .

  16. Age Friendly Portland Logo

  17. facebook

  18. Age Friendly Portland

    Age Friendly Page 4

    Please state your comittment to the Age Friendly Portland Business or Organization designation, and the vision of Portland as an Age Friendly communiity by filling out the section below. This commitment statement should be signed by your business or organization President, Executive Director or Chief Executive Officer.

  19. Age Friendly Promise:

    We are committed to making our business or organization Age Friendly by striving to provide easy-to-navigate, respectful, positive and effective experiences and services to our community.

    We support the vision of Portland, Maine as a community that encourages active and heathy living and provides a more accessible, affordable and socially engaging place for all ages and abilities.

    We will notify the Portland Office of Elder Affairs of any significant changes that affect our ability to be Age Friendly.

  20. Age Friendly Portland Logo

  21. facebook

  22. Leave This Blank:

  23. This field is not part of the form submission.