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Senior Registration

Senior Registration

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If you or someone you know can benefit from the joys and friendships of the Sunshine Circle, what are you waiting for? Enroll in the program today. Great care is taken to match up each senior with just the right volunteer for maximum compatibility and synchronicity.

Remember, the Sunshine Circle is all about friendship and mutual enrichment.

For further information or to enroll, please call (949) 831-7701, or fill out the form below. You can also print or download this form and mail it in.

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SENIOR INFORMATION
First Name:
Last Name:
*E-Mail:
   We're old friends - You have my information! (skip address section)

Resides in: Own Home Senior Facility Other
Address or Facility Name:
City: State:
Phone #: Zip:

Age:      Gender: M F  
VOLUNTEER PREFERENCES
Preferred Day(s):  S  M  T  W  Th  F
 
Best Time of Day:  Mornings (AM-12PM)
   Afternoons (12 PM-5 PM)
   Evenings (5 PM-PM)
   Other
 
Frequency:  Weekly  Bi-monthly     Monthly
   Other
 
Preferred Language:  English  Yiddish  Hebrew
   Spanish  French  German
   Other

Do you have any hobbies or special interests you would like to be able to share with your visitor?

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