This is for those that would like to be able to help others that want someone to talk to. Please fill out this form and send it into us so that we can process it and get you ready to help. Please note that we strictly prohibit any inappropriate action and/or behavior including but not limited to: inappropriate Sexual related conduct, promotional attempts, religious, references, solicitation and/or political opinions. Basically behave and use you best judgment.

Also expect some messages you receive to be rude and disrespected etc. remember they are in need, but every once in a while there will be people that just did it to be annoying please ignore them and let us know.

Real name:

Name wish to be called by:

What are you:
Pasture, Priest, Minister, or any other religious type person of honor (not limited to the Christian faith). Your Religious Title
Religious person, has a faith of
Psychiatrist - Where, when, title
Psychologist - Where, when, title -
Counselor (AA, student/school councilor, etc.) IF YOU have had Prier training. Doing what?
Student of one of the above
Other not specified or just won't to help.

Age/birth day:

Address:

E-mail:
Do you wish to keep your email account private from the ones you council? yes

Please write and explain why you wish to help and a little about yourself.