INSTRUCTIONS (PLEASE READ):

My name is Rebekah Samuel and I am the main founder and coordinator of LoveYourNeighbor514, an organization for senior care.

Jan House is the founder and coordinator for SAG (Seniors Aging Gracefully).

We are forming a partnership to partner our resources and reach more seniors for connection, serving, friendships, and care. We invite you to come join us, be paired with a volunteer for connection and reach out, as well as be connected with a community of seniors you can interact with directly.

Volunteers:
I am gathering information from each volunteer so we have a roster of contact information.
What I am needing from you is in section 2 if you're a volunteer. All information is seen only by the organization admins.

Recipients:
If you’re not a volunteer and are someone in need please go to the Recipient section 3 of this form and share the information that applies. If you can be both a volunteer in ways while homebound and are a recipient, fill out both and whatever applies to you. We are making a roster of those in need as well.