Adopt A Grandma (Senior Form)

Welcome to the official Registration page of the Adopt A Grandma program provided by the Black Community Resource Centre's (BCRC) Intergenerational Health & Social Services Program 🎉

This program offers a fantastic opportunity for Black seniors to connect with immigrant families who have recently arrived in Quebec. Through engaging and informative activities, all members can develop meaningful relationships that last a lifetime. As a mentor, you have the unique opportunity to share your life experiences and wisdom with younger generations, while also learning from them.

To become a mentor, kindly fill out the registration form below and select a date and time that works for best for you for the information session.

If you have any questions, please do not hesitate to contact us by email at communications@bcrcmontreal.com, or by phone at 514-342-2247 ext. 101. Please note that all applications are handled with utmost confidentiality and reviewed with care.

First Name*

Last Name*

Email Address*

example@example.com

Phone number*

Street address 1*

Street address 2

City*

Postal Code*

Date of birth*

Date

EnglishFrenchOther

What is your cultural background?*

What is your spiritual or religious background?*

Please tell us why you are interested in the Adopt-A-Grandma Program and/or tell us what you hope to experience.*

What kind of activities or hobbies do you enjoy, and are there any you'd like to explore with your mentees?*

What values or traditions from your family or culture do you hope to share with your adopted family?*

What's a fun fact or unique talent you'd like your mentee to know about you?*

I certify to the best of my knowledge all my responses are accurate and truthful.

Please verify that you are human*

Adopt A Grandma Registration Form

Contact Information

Qualification Questions

Getting to know you

Information Session