Intentional Deep Experiences Across Lifecycles

Sample Grandfriend Application*

*Please use our sample to inspire your work in a way that fits the needs of your particular community.

Today’s Date ___________________


First Name      ___________________ Last Name__________________________

Local Address ___________________ City _______________________________

State ___________________ Zip ________________________________

Home Phone  ___________________ Cell Phone __________________________

Email ___________________ Emergency Contact  __________________

(EC) Phone ___________________ (EC) Relationship ____________________

Date of Birth ___________________ Birth Place __________________________


Do you use: (circle)

Email?   YES   NO FaceTIme?    YES NO   

Zoom?   YES   NO Whatsapp?    YES NO

Do you have grandchildren at this school? If yes, who?


Do you have grandchildren in the area? If so, where? 


What motivates you to become a grandfriend? 


Please indicate the days and times during the week that you are available to volunteer: 

*Please note that this commitment requires a minimum of 2 hours per week. 

Monday_________ Tuesday_________ Wednesday___________ Thursday__________ Friday __________

What date are you available to begin? _____________________________________________

*Prior to your start date, we will need to complete necessary DCFS paperwork such as background check and medical.