VOLUNTEEN APPLICATION

VOLUNTEEN APPLICATION
PERSONAL INFORMATION
Date of Birth

MonthDayYear
Date
Name

First NameLast Name
Address
City
Postal Code
Mobile Phone Number
Format: (000) 000-0000.
Email
example@example.com
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Format: (000) 000-0000.
EDUCATION & REFERENCES
School Name
City
Grade Level
References - List three references who are not family members.
Name and Relationship
Years Known
Phone
Format: (000) 000-0000.
Name and Relationship
Years Known
Phone
Format: (000) 000-0000.
Name and Relationship
Years Known
Phone
Format: (000) 000-0000.
SKILLS
List any skills that you could use while volunteering (computer skills, presenting, etc.)
1.
2.
3.
TELL US ABOUT YOUR VOLUNTEERING INTERESTS AND PREFERENCES
Please share how you heard about Treasure Coast Hospice and why you'd like to volunteer with our organization.
Hospice House Front DeskEvents and Community FairsCopying, Printing and Packet AssemblyComputer - data entry or graphic designGrounds and Facilities
MondayTuesdayWednesdayThursdayFridaySaturdaySunday8 am to NoonNoon to 4 pmOther
Are you only available to volunteer until a certain date? If so, list here.
ACKNOWLEDGEMENT
I certify that all answers given herein are true and complete to the best of my knowledge. I authorize Treasure Coast Hospice to investigate all statements contained in this application as may be necessary to volunteer for the organization I understand that volunteers under the age of 18 do not have direct patient interaction. Should I wish to volunteer beyond the age of 18, I understand I will be required to undergo the full Treasure Coast Hospice volunteer onboarding process and orientation.
Volunteer Signature

Clear
Date

MonthDayYear
Date
Parental Approval (Signature)

Clear
Date

MonthDayYear
Date
Should be Empty:

VOLUNTEEN APPLICATION

PERSONAL INFORMATION

EDUCATION & REFERENCES

SKILLS

TELL US ABOUT YOUR VOLUNTEERING INTERESTS AND PREFERENCES

ACKNOWLEDGEMENT