Pen Pals for Seniors Interest Form

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Thank you for your interest in Pen Pals for Seniors! Please complete this form if you or someone you know wants to be a pen pal so we can match you up with someone with similar interests.

Pen Pals for Seniors is a letter-writing program I started in September of 2017 between students in the Tempe Elementary School District and senior citizens throughout Tempe and the East Valley (or anywhere in Arizona or nationwide, if the interest arises). The program was created to help decrease the feeling of isolation and loneliness among seniors and young people as well as give the students and the seniors someone outside of their everyday circle to talk to and even develop a friendship/relationship with. The pen pals write letters and notes back-and-forth about every two weeks during the school year, with a face-to-face meet-up at the end of that school year (for those who are in Arizona), so they can see who they have been writing to.

Watch our videos from previous year's Pen Pals for Seniors Program:

Students from Ward, Scales, and Mosley Middle School Meet Their Pen Pals - May 2023

Tempe First United Methodist Church and Scales Technology Academy

Friendship Village and Ward Traditional Academy

If you or someone you know is interested in participating in the Pen Pals for Seniors Program, please complete this form.

If you have questions or concerns, please contact Amy Garza at penpals@tempeschools.org or (480) 730-7140.

Email *

Are you a student or a senior? *

Student

Senior

Today's Date *

YYYY

Are you completing this form for yourself or someone else?

Myself

My parent

My grandparent

My child

Other:

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Please enter first and last name of interested pen pal participant. *

Mailing address of interested pen pal participant: *

Tell us a little about yourself, so we can match you with another interested pen pal participant. (Examples are: favorite color, favorite foods, favorite subject in school, hobbies, books/movies/games of interest, pets, favorite type of music, etc. You can include your age, if you would like.) *

Why are you interested in the Pen Pals for Seniors Program? (Check all that apply) *

I think it will help improve letter-writing skills.

I think it could develop a friendship/relationship between the participants.

I think it may help the participants feel special or less lonely.

I am looking forward to sending/receiving letters.

It seems like a great experience.

I am interested in the face-to-face meet-up at the end of the school year.

I know someone else who participated, and I also want to become involved.

I think it is a positive way to make a connection in my community.

Other:

Required

How did you hear about the program?

Website: www.tempeschools.org/penpals

Flyer about the program

Social media: Facebook or Instagram

Word of mouth – someone told me about the program

Heard about it an an Expo I attended

Other:

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Comments: (Is there anything else you would like us to know about you or do you have any questions?)

Submit

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