Singleton Phonebook - The Singletons

Singleton Phonebook is a resource of community professionals and businesses which are willing to provide their services to Valley single parents with cancer, and their children, on an as-needed, pro-bono basis.

It also provides a unique and hands-on opportunity for community members to give of their time, talents, and expertise in a way that is rewarding, appreciated and helps to fill needs which would otherwise go unmet.

If you would like your business to be a part of Singleton Phonebook, please download an application form or use the online form below.

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Your Company Details
Company Name*
Address*
Street Address Address Line 2 City State ZIP Code
Contact Person*
First Last
Email*
Phone*
Website
How did you hear about Singleton Moms*
Your Services
Service Information*
Is there a limit to the number of parents, number of services, or in-kind dollar amount, which you are willing to provide to Singleton Moms families per year? If so, please specify above (can be changed at any time)
Who is eligible for your services?*
- Only parents currently in treatment eligible
- Current and former (graduate) parents eligible
Are former Singleton Moms parents, who may have finished cancer treatment but still have a need, also eligible for your services?
Can we give you credit?*
- Yes
- No
May we give credit to your business on the “Singleton Phone Book” page of the Singleton Moms website, on our Facebook page, and in e-newsletter articles?
Commitment of Services
I freely choose to give of my professional services to the families served by Singleton Moms, and am authorized to make this commitment. I understand that by signing below, the commitment I am making to Singleton Moms is on a “pro bono” basis; and that neither the families served, nor Singleton Moms, will be charged for any services provided.
Signature*
Phone
This field is for validation purposes and should be left unchanged.

Your Company Details

Your Services

Commitment of Services