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Rocky's Agency on Aging

iPad Application

Rocky's Agency on Aging iPad Loan Program

Please take the time to fill out this application completely. Incomplete forms may not be considered.

Information about Potential Recipient

First Name
Last Name
Country
Address Line 1
City
State/Province
Postal Code
Does the individual reside in a private home, assisted living, or a nursing home?
Month
/
Day
/
Year
Does the applicant have Wi-Fi available?

Caregiver Contact Information

Country
Address Line 1
City
State/Province
Postal Code
First Name
Last Name

COVID-19 intensifies social isolation among older Montanans. Rocky’s Agency on Aging will provide for free for qualified recipients, one iPad per client living in these counties: Broadwater, Gallatin, Jefferson, Lewis and Clark, Meagher, and Park. Funding for the offerings comes from the CARES Act and a donation by Blue Cross Blue Shield.

Printable iPad Application

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