Student Volunteer

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Work with me

Primary member details

Name of Member

School Batch (Year)

Fathers Name

Mothers Name *

Place of residence

Parents

Self

Your contact details

Your Support for OurParents initiative

State / District / Village / Location for which the data is provided:

Kindly assist with the following information to build database of support for Our Parents.

You may list one or more contact for any of the below mentioned services:

Contacts for Medical services?Pharmacy for Allopathic medicines, Pharmacy for Ayurveda/ Homeopathy medicines, Diagnostic/Lab centers, Lab technician for home visits, Specialty Clinic Multi-specialty hospital, Specialist doctor, Ambulance service Caregiver service, Assisted care service, Dementia care service, Health Insurance agents

Contacts for Leisure Activities:Clubs, Yoga instructor, Physio / Fitness trainer , Tour Operator, Errand boy , Hospital Escort ,Doctor for Health talk, Eminent Politician , Literate Scholar , Special dignitary , Ex-servicemen , Others

Contacts for Home Services :Gardener, Electrician , Plumber , Carpenter, Mason , Painter , AC Mechanic , Electronics repair , Car Mechanic , IT technician , Food delivery , Supermarket for homedelivery

Contacts for Essential Service :EB , Water department, Advocate , Police , Fire Service , Cyber crime ,s Banking services , Pension office , Panchayat/Corporation , Senior Citizens help centre

Have your parents enrolled for the OurParents program

YesNo

If ‘NO’ please share the reason:

Any other suggestions :

Would you wish to volunteer as member of the support group for OurParents:

YesNo

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Student Volunteer

Work with me

Primary member details

Place of residence

Your contact details

Your Support for OurParents initiative

Have your parents enrolled for the OurParents program

Would you wish to volunteer as member of the support group for OurParents:

Site Map

Subscribe Now

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