Golden Memories Program Application 2025

At Ideal Caregivers 4U, we believe in honouring the golden years of our seniors by providing them with exceptional care and enriching experiences. Our 'Golden Memories Program' is a heartfelt initiative designed to enhance senior care services across Canada, ensuring that every elderly individual can age gracefully while surrounded by love and support.

We understand that not all seniors have the means to access the services they require, such as personal care, meal assistance, or companionship opportunities. Therefore, we invite those who are less fortunate to apply for our Golden Memories Program.

To ensure that we are able to assist those who truly need it, proof of income will be required as part of the application process. Acceptable documentation may include a recent Notice of Assessment or similar financial statements. We are committed to ensuring that every eligible senior has the opportunity to enjoy the support and services they deserve, free of charge.

This initiative is made possible through the generous donations from compassionate community members who understand the importance of caring for our elders. Their contributions allow us to provide these essential services without financial burden to those in need. We are incredibly grateful for the support we receive, which enables us to make a meaningful difference in the lives of seniors and enrich their experiences during this vital stage of life. Together, we can create a nurturing environment where every senior feels valued and cared for.

Name

First NameLast Name

Date of Birth

Date

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Proof of Address

Proof of Address includes any document, such as utility or phone bill, credit card statement, etc.

Phone Number

Please enter a valid phone number.

Email

example@example.com

Monthly Household Income (before deductions):

Do you receive any financial assistance?

YesNo

If yes, please specify:

Do you have any savings or assets?

YesNo

If yes, please specify:

Please check to identify specific eligibility requirement met. Upload document(s) in the section below:

Receipt of Ontario WorksReceipt of Essential Health and Social SupportsReceipt of Ontario Disability Support Pension (ODSP)Receipt of a Guaranteed Income Supplement (GIS)Current Notice of Assessment (NOA)

Proof of Eligibility Requirements:

Upload documents here

Please briefly describe the services you require (e.g., meal preparation, light housekeeping, companionship, personal care, etc.):

How often do you require these services?

If you selected "other", please specify:

Are there any specific challenges you are currently facing that make it difficult for you to maintain your daily activities?

How did you hear about the Golden Memories Program?

TERMS OF SERVICE

Disclosure in connection with electronic communications and e-signatures
Please note that by clicking continue and signing this document generated on www.idealcaregivers4u.com you agree that you have reviewed the following disclosure and consent to

(i) transact business by electronic means;
(ii) receive documents electronically; and
(iii) use the Ideal Caregivers 4u Inc. e-signature system.

You are not under an obligation to receive documents electronically or use the Ideal Caregivers 4u Inc. e-signature system. You may request to receive hard copy paper documents instead and withdraw your consent at any time by the procedure below. The field is required.

Withdrawing consent
You may withdraw your consent to receive electronic documents from Ideal Caregivers 4u Inc. at any time. To withdraw consent, you must notify the sending party that you wish to withdraw consent by emailing the sending party directly. Please note that after you withdraw consent, if you choose to proceed after such time and use the Ideal Caregivers 4u Inc. e-signature system, you are consenting to receive and sign documents electronically. You can withdraw consent after the time you consent to use the system by following the procedure outlined above.

Scope of consent
You agree to receive electronic documents and use the Ideal Caregivers 4u Inc. e-signature system with all related and identified documents provided during your relationship with the sending party. You may withdraw your consent by following the procedures described above.
By clicking the Submit button,

I agree to the terms of service.
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Signature of Applicant, Legal guardian, or Power of Attorney:

Golden Memories Fundraiser Application 2025

Personal Information

Financial Information

Care Needs

Additional Information