Senior's Saturday
Senior's Saturday, October 26, 2024, is about asking residents of Leader and surrounding communities to press pause, take note of any seniors who could use a little assistance and offer an act of service and support.
Survey of Needs and Acts of Service
This form is one tool of many to help us get a sense of what the needs and abilities are of those in the community of Leader and surrounding area.
What age category do you fall into? (Please select one)
Please Select
11 - 15
16 - 20
21 - 30
30 - 65
66 - 75
76+
I am a senior and/or have physical mobility limitations and I could use extra assistance with the following (Please select all that apply):
Raking Leaves
Socializing (Coffee and/or Tea)
Picking up groceries
Washing Windows
Cleaning Gutters
Running Erands
Not applicable
Other
I am able to assist with the following: (Please select all that apply):
Raking Leaves
Socializing (Coffee and/or Tea)
Picking up groceries
Washing Windows
Cleaning Gutters
Running Erands
Not applicable
Other
Would you like to be matched/paired so you can participate in Senior's Saturday too?
Yes, please.
No thank you, I have a senior in mind and I will reach out to them to offer my assistance.
Other
Request for a match/pair
You are not required to complete this form to participate in Senior's Saturday. However, as this is an initiative supported by a small group of independent volunteers looking to build connection, we understand a little connection and introductions go a long way. If you answered "Yes" in the question above, and provided your contact details below, someone will reach out to you to help facilitate a match.
Name
Phone Number
Email Address
Request to be involved in a more formal way
Complete the following if you would like to participate in an ongoing discussion group and/or receive information about supporting seniors and aging-in-place within the community. Please ensure you have included your name and contact details in the previous section.
Select all that apply
I am an individual and I would like to participate in future discussion groups about supporting seniors and aging in place with the community.
I represent another community-based organization and would like to participate in future discussion groups about seniors and aging-in-place so that more service groups and/or non-profit groups are able to coordinate their services and outreach.
I don't want to attend a discussion group, but I woud like you to keep my contact details handy so I can receive an email notification for other events and projects similar to "Senior's Saturday".
Other
Submit
Should be Empty: