Please print and fill in the form below if you would like to Adopt A Senior.

Name
Address
City, State
Zip Code
E-mail
Telephone
Comments

Please mail this form with your check ($45 for each senior you'd like to sponsor) payable to:

Ramona Snell-Adopt a Senior
P.O. Box 326,
Bar Mills, Maine
04004-0326

Thank you!
Call 207-929-6166
or 929-5318 to use Mastercard or Visa or if you have any question.