Grandparent Sign Up Questionnaire This form can be completed with the assistance of the care service if required. Name * First Name Last Name If you live in a care home, please provide the name of the home below: * What do you prefer to be called? * How old are you? * What is your date of birth? * MM DD YYYY What is your gender? * Male Female Other Prefer not to say What is your nationality? * Where were you born? * What languages do you speak? What was your former profession? * What are your current hobbies and interests? * What do you like to do in your spare time and what brings you joy? * Please tell us a bit about the person you would ideally like to talk to. You can be as specific as you like and we will do our best to find you a match. * For example, ''I would like to talk to someone who lives in my hometown and is working as a postman as my father was a postman. I don't mind how old they are or if they are male or female. It would be really helpful if they were familiar with my culture and spoke my mother tongue''. Please provide, as best and specifically as you can, days and times during the week you are able to speak to your volunteer * Consent to Adopt A Grandparent processing your personal data: * I hereby give consent to Adopt a Grandparent to store, process and publish the photos/video/audio recordings taken of me in both print and digital form. Thank you!
