Senior Watch Programs

Senior-Watch-1

Poland Township Senior Watch Programs

The Poland Township Trustees have sponsored the “Poland Township Senior Watch Programs” mainly for the benefit of township’s senior citizens, but others may benefit as well. Shut-ins, wheelchair bound or SSL recipients are some additional examples.

The Poland Township Senior Watch Program application form is available below for download. The completed application can be fax to 330.757.1152 or mail to:
 
Poland Township Senior Watch Programs
3339 Dobbins Road
Poland, OH 44514
 
In addition, you can complete the online version of the form, available at the bottom of this page.
 
Download:

Online Form:
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Please complete the pertinent information for the senior citizen or individual needing Senior Watch services:
Please type your full name.

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Application Requested by:
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Physician Family/General information:
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1st Emergency Contact (Family Neighbors/Friends):
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2nd Emergency Contact (Family Neighbors/Friends):
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Last page—Submit Form!
Additional Information (Outside key/lockbox/etc.):
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