Telepals Participant Application

Do you know someone who would benefit from connecting with someone in the Tampa Bay community?

Then look no further! Telepals connect individuals through the phone.

Currently, we offer this service in Florida in Hillsborough, Pasco, Pinellas, and Polk County.

1. Referral Name (First and Last) *This question is required.

2. Referral Primary Phone Number (Número de teléfono primario) *This question is required.

3. Referred by (enter None if you found us on your own. Please include your name and organization name if you are with an organization): (Referido por): *This question is required.

Seniors in Service does not and shall not discriminate on the basis of race, color, national origin (including limited English proficiency), sexuality, political affiliation, religion, or on the basis of disability.

4. Comments (Comentarios):

Telepals Participant Application

Info Gathering