Adopt a Grandparent: Volunteer Registration
Please fill out this application so we can match you with a new companion!

We have created this program to make new connections in our community and keep people socializing from a safe distance during COVID-19. We welcome volunteers of all ages and demographics. Once you have been matched with a companion, you will receive each others' contact information and be able to create a relationship based on your shared preferences - you can agree on Sunday afternoon phone calls, unscheduled calls, weekend video chats, shared projects or activities, etc. We will match you based on personality and interests, as well as schedule and availability. If there is anything else you would like us to consider, please let us know in your application!

You can always reach out to us for support or ideas, but our goal is to let you and your companion shape a relationship that works for both of you. We understand that your schedule may become busy after COVID-19, and we only ask that you be kind and communicate with your companion if you need to take a break from the program.

For questions, comments or concerns, please contact:
Carla Toolan, Community & Research Coordinator at WVU Health Sciences: carla.toolan@wvumedicine.org
Jessica Maloy, Life Enrichment Manager at Berkeley Senior Services: bssadmin1@berkeleyseniorservices.org
The "Adopt a Grandparent" program has been created to build meaningful relationships. We ask that before you sign up for this program, please consider if you will be able to donate at least 1 hour per week of your time. If you feel confident in your ability to commit to this, please proceed! If not, please keep us in mind and tell your friends about us! *
Required
Full name: *
Your answer
Age: *
Your answer
Are you volunteering with us through an organization? If so, please list their name here.
Your answer
Will you be claiming service hours for your participation?
If you are under 18 years old, please enter a parent/guardian's name and contact information (phone or email) so we can get permission for your participation:
Your answer
Preferred Phone Number: *
Your answer
Preferred Email Address: *
Your answer
How much time per week could you usually spend with your companion? *
Please tell us about basic times you can be available (choose all that apply).
Anytime
9am-12pm
12-4pm
4-8pm
Sundays
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Why would you like to participate in the Adopt a Grandparent Program? *
Your answer
Where did you hear about our program? *
Please tell us about yourself and include at least 3 hobbies or interests. Where are you from? Where do you work or go to school? What is your favorite holiday, music genre, etc.? The more information you can provide, the better we can find a good match! *
Your answer
If you would like to add any notes to your application, please include them here.
Your answer
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