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What is Jiobit
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Apply For A Package

This is the application for Boomers 1 year Package which includes the following :

- 5 pairs of Boomers
- 1 Jiobit GPS tracker
- 1 year subscription to Jiobit.

If interested, please take the time to fill this out and provide us with as many details as you can. The applications are reviewed by our selection committee quarterly.

Application Form

Parents/Legal Guardians Names:

Is your primary residence Maryland?

Yes NO

Address

City

State

Zip

Best Phone Number

Email ID

Child Details
Name of Child

Child’s age

Is the child verbal? (Speak fluently?)

Yes No

How many other minor children in the household?

Do other child/ren in the house have a disability? (If yes, please give details)

Tell us about your autism journey thus far and how a Boomers package could help your family.

Do you live close to a high risk area (lake, pond, river, ocean, high traffic – please give details).

Has your child ever eloped? If yes, please explain.

Do you have an IOS (Apple) or Android device to link the Joibit device for notifications?

Yes No

Do you acknowledge that if you are chosen, the Jiobit device will be provided with a 1 year of pre-paid service. After the 1 year is up, Boomers Inc is NOT responsible for continuing service? (Recipient CAN continue service by paying a monthly service fee to Jiobit)

Yes No

Do you acknowledge that Boomers Inc can only provide as many packages as donations allow? This application is NOT a guarantee that a package will be awarded to you.

Yes No

Do you acknowledge that Boomers Inc is not responsible for cell phone carrier data charges?

Yes No

Do you attest that NO product is perfect? Boomers Inc, its board members, and sponsors are in NO way liable for use or malfunction.

Yes No

Do you acknowledge that you must have legal custody to receive a package from Boomers Inc?

Yes No

Do you acknowledge that the tracking device, Jiobit, in the Boomers package requires set up (download app, pair with device) and ongoing charging as needed?

Yes No

Do you attest all information is true and correct?

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