Volunteer Application Form

Please fill out if you are interested in becoming a volunteer with St. Joseph's Hospice. Your information is kept confidential and secure.
  • Please include middle initial.
    First Name
    Last Name
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  • EMERGENCY CONTACT
  • First Name
    Last Name
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  • WORK EXPERIENCE
  • EDUCATION
  • VOLUNTEER EXPERIENCE
  • VOLUNTEER POSITIONS
  • When are you available to volunteer? (write all that apply)
    Please specify a start and end time.
  • General Information
  • In-Home & Transportation
  • For positions involving driving clients, the following requirements are expected:
  • For Complementary Therapists, Estheticians & Hair Stylists Only:
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  • All prospective St. Joseph's Hospice volunteers must complete a Criminal Reference Check and Vulnerable Position Screening. You must submit the completed check before being accepted into the Hospice Volunteer Training Program.
  • PERSONAL EXPERIENCES
  • STRESS MANAGEMENT
  • I understand that the information provided in this application to volunteer with St. Joseph's Hospice is part of a permanent volunteer file and is only available to St. Joseph's Hospice staff. The information will be used to complete the volunteer screening process. I certify that all the statements made on this form are true, complete, and correct. I authorize St. Joseph's Hospice to contact the references I have provided. I understand that any false information on this application will be cause for termination as a volunteer.
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  • VOLUNTEER REFERENCES
    As part of the screening process to become a Hospice Volunteer, we ask you to provide 2-3 character references. These references are to be a combination of personal (other than relatives) and professional associations from individuals over 18 years of age who you have known for over 2 years.
  • First Name
    Last Name
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  • First Name
    Last Name
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  • First Name
    Last Name
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  • I give my permission to the Coordinator of Volunteers, or designate, to contact these individuals by mail, telephone, fax or e-mail.
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