Friendly Caller Senior Sign Up

Friendly Caller Sign Up
Interested in signing up for the Macomb County Office of Senior Services' Friendly Caller program?

Complete form below.

Eligibility: Macomb County Resident and 60 years or older.

* Indicates required question.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How often would you like a social call with one of our volunteers?*

WeeklyEvery two weeksMonthly
Best day to call (check all that apply)*

MondayTuesdayWednesdayThursdayFriday
Best time to call (check all that apply)*

AMPM
We will do our best to match you to a volunteer who can call you at your preferred day and time.
Should be Empty:

Friendly Caller Sign Up