Senior's Wednesday Registration Form (British Columbia)
Islamic Relief Canada matches volunteers with seniors, providing new social connections through a weekly phone call. This program is available to residents across British Columbia.
 
If you know someone who could benefit from this program please fill out this form.
Name of senior being nominated for this program *
Senior's phone number *
Address of Senior *
Language preferences *
Required
How would this individual benefit from this program and weekly phone calls? *
Referred by (your name) *
Your phone number *
Additional comments
Submit
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