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VIRTUAL COMPANIONS

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You can create an account to register yourself or a loved one to join the Virtual Companions community.

After creating an account and confirming your email, you can complete the training and join programs.

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First Name

Last Name

Password

Phone Number (optional)

What's your preferred method of contact? *

Which best describes your interest in Virtual Companions? *

The account information above should be for the person joining the program.. Below, please provide your contact info.

First Name *

Last Name *

What is your relationship to the person who will be joining the program? *

The following questions should be answered about your loved one.

Who do you want to connect with? *

Generation *

What technology do you have access to? (select all that apply) *

Smartphone

Telephone

Tablet

Computer

Zoom (video conferencing app)

What languages are you fluent in? *

English

Spanish

Chinese

Tagalog

Other

Introduce yourself (we will share this blurb with your companion). *

Any experiences relevant to interacting with other generations? *

Describe your group. *

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How did you hear about us? *

Why do you want to join? *

Any comments/concerns/special requests?

Are you at least 18 years old? (otherwise some activities may require parent consent) *