|
Volunteers play a vital role in hospice care and help provide activities that can enhance quality of life while bringing true joy to patients facing terminal illnesses. Volunteers are also important in easing the burdens associated with end-of-life care for families and loved ones. Volunteers are friends and supporters to patients and their families, not experts or authorities. No prior medical knowledge is necessary.
If you would like to talk to someone or learn more about volunteering with Sanctuary Hospice, please feel free to contact us.
|
Volunteer Application
Required fields are marked with an asterisk (*).
|
|
|
|
First
|
Last
|
|
|
|
|
|
|
Street Address
|
|
Address Line 2
|
|
City
|
State / Providence / Region
|
|
Zip
|
Country
|
|
|
|
|
|
|
OTHER
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Date
|
Location
|
REFERENCES
|
|
- - - - - - Reference #1 - - - - - -
|
|
|
|
First
|
Last
|
|
|
|
Street Address
|
|
Address Line 2
|
|
City
|
State / Providence / Region
|
|
Zip
|
Country
|
|
|
|
- - - - - - Reference #2 - - - - - -
|
|
|
|
First
|
Last
|
|
|
|
Street Address
|
|
Address Line 2
|
|
City
|
State / Providence / Region
|
|
Zip
|
Country
|
|
|
EMERGENCY CONTACT INFO
|
|
|
|
First
|
Last
|
|
|
|
Street Address
|
|
Address Line 2
|
|
City
|
State / Providence / Region
|
|
Zip
|
Country
|
|
|
BACKGROUND INFORMATION
|
|
|
|
Have you experienced a loss of someone close to you in the last year?
|
|
|
|
|
|
What is your educational background?
|
|
Employment Status
|
|
|
|
|
|
|
|
|
|
Areas of Volunteer Interests (check all that apply)
|
Languages Spoken (Check all that apply)
|
|
|
|
AVAILABILITY
|
|
Preferred Days (Check all that apply)
|
Preferred Times (Check all that apply)
|
|
|
|
|
|
|
|
When are you available to attend training?
|
I certify that all information provided in this application is accurate, current and complete. I understand that any false information or omission may disqualify me from volunteering and may result in my dismissal if discovered at a later date. I authorize Sanctuary Hospice and/or its agents to investigate all statements contained in this application for volunteer work as may be necessary, including but not limited to a background search / verification, criminal record search, driving record, education and licensure certification. I further authorize law enforcement authorities to release any information concerning my background and herby release authorities from any liability for any damage whatsoever for issuing this information. I understand that I will participate in a volunteer interview and extensive training and must agree to abide by all policies, regulations and guidelines established by Sanctuary Hospice. I understand that this application will not be considered if questions are left unanswered or it is not signed.
|
|
Please Type Your Name Below
|
|
First
|
Last
|
|
|