Would you like to have someone read to you (or someone you know)? Sign up to be a "Listening Buddy". Please complete all questions and submit. Once completed, we'll work to locate a volunteer Reading Buddy. Contact information: If this form is being completed by someone OTHER than the Listening Buddy, please provide us with your name and phone number here (family member or friend):
First and Last Name of person in need of reading ("Listening Buddy")**
Provide phone number "Listening Buddy" is planning to use**
City, State/Province, Country of "Listening Buddy"**
Calling [choose one]:** "Listening Buddy" HAS a free/cheap long distance plan and can call the assigned volunteer Reading Buddy.
"Listening Buddy" DOES NOT HAVE a free/cheap long distance plan and needs a volunteer Reading Buddy to call. Calling time [choose one]:** The best time of the day for the "Listening Buddy" to be read to is:
any time mornings afternoons evenings Calling frequency [choose one]:** The "Listening Buddy" would appreciate being read to at this frequency:**
daily [weekdays only]
weekends only
7 days a week
only certain days during the week: [indicate which days in this box] Language:** The "Listening Buddy" would like to be read to in this language: English Spanish French German Any other special instructions, questions, or information:
Contact eMail address (optional): eMail Address of person completing this form (if you have one)
Re-enter eMail Address
Once the "submit" button below has been clicked, we will go to work to match the "Listenging Buddy" with a volunteer Reading Buddy. Thank you! We will be in contact soon. | 
