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Adopt a Senior
Survey of volunteers
1.
Are you interested in helping a senior in our community during the COVID-19 social isolation period?
Yes
No
2.
What activities can you help with?
Grocery buying and drop off
Calling to check in on needs
Other (please specify)
3.
Are you 18 years old or older?
Yes
No
4.
Please provide contact information
Name
Address
Email Address
Phone Number
