Chatting to Wellness Online (Phone Call) Chatting Sessions Registration
This form is for you (a senior) to register yourself for an Online (Phone Call) Chatting Session.
Name *
Age *
Address *
Email
Phone Number *
What day(s) are you available for a call? (Calls are between 6pm-9pm) *
Required
How frequent should the calls be? *
Do you have access to a computer and/or a smart device? *
I agree to the terms and conditions of Online Chatting Sessions and for communications (Found here: https://bit.ly/3e3pCHJ) *
[OPTIONAL] Additional Comments (language, hard of hearing, extension number, etc.)
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy