• Hospice of Jefferson County Volunteer Application

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  • Emergency Contact

    In case of an emergency please notify:
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  • Education




  • Skills



  • Experience

  • Desired Area of Volunteering

    (Please check all that apply)

  • Three Personal References

    (Please provide complete address)
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  • Reference 2
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  • Reference 3
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  • CODE OF ETHICS FOR VOLUNTEERS

    As a volunteer, I realize that I am subject to a code of ethics similar to that which binds the professional in the field in which I work.  I, like them, assume certain responsibilities and expect to account for what I do in terms of what is expected of me.

    I understand that any information that is disclosed to me while assisting the hospice is confidential.

    I interpret “volunteer” to mean that I have agreed to work without compensation in money.  Having been accepted as a volunteer worker, I expect to do my work according to the standards set forth in the Volunteer Policies and Procedures.

    Declaration

    I hereby certify that the statements made on the application are true and correct to the best of my knowledge.  I understand that, by submitting this application, I authorize inquiries to be made concerning my employment, character and public records for the purpose of determining my suitability as a volunteer.  I affirm that I have read the volunteer Code of Ethics and agree to abide by its regulations.  I agree to respect the confidentiality of any client information I acquire in the course of my volunteer activities with hospice.

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