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Fields marked with an asterisk (*) are required.

Please enter phone numbers like this (XXX)XXX-XXXX

Please enter the full date of birth using only numbers. EX: 06/01/1954

By clicking this box, I confirm that the person being signed up to receive these calls is 18 years of age or older.
I understand by submitting this form I am asking for myself, or a call recipient I am assisting, to receive phone calls from an L.A. Works TeleSocial Volunteer. I understand that "TeleSocial" means that these calls are strictly social, conversational calls, wherein the dialogue is intentionally steered toward common interests and no medical, financial, or other advice on other services will be given by the volunteer. I understand that the call volunteer will only receive the first name of the call recipient and the call recipient phone number will be hidden by the Call Hub system and that any further personal information shared in the phone conversation is considered confidential. I understand that the role of the call recipient is to simply receive social calls from the volunteer caller. The call recipient will know not to breach the boundaries of this program by asking for advice. I understand that any further questions about the program can be answered by an L.A. Works Staff member.