Volunteer Application

Volunteer Application

Seasons Hospice, Rochester, MN
Thank you for your interest in volunteering at Seasons Hospice in Rochester, MN. Please complete the following application and we will be in contact with you. We appreciate your interest in volunteering and look forward to connecting with you.
I am applying to volunteer at Seasons Hospice in Rochester, MN.*

Yes
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Phone Number (optional)
Please enter a valid phone number.Format: (000) 000-0000.
Email*

Confirmation Emailexample@example.com
Preferred contact method?*

PhoneEmail
Do you have access to a computer and/or email?*

YesNo
Volunteer experience*
How did you hear about volunteer opportunities at Seasons Hospice?*

Social Media"Just Serve" websiteCommunity EventReferralCurrent VolunteerOther
Name of Community Event*
Name of Referral*
Name of Volunteer*
What specific areas are you interested in volunteering for? Check all that apply.*

Visiting patients/familiesOffice assistanceBereavementSpecial Events or Community EventsVeteran Honor visits (Active Duty or Retired Vet required)
Are you generally able to commit a minimum of four hours per month of volunteer time?

YesNo
What days of the week are you available to volunteer? (check all that apply)*

FlexibleMondayTuesdayWednesdayThursdayFridaySaturdaySunday
What time of the day are you available to volunteer? (check all that apply)*

FlexibleMorningAfternoonEvening
If you are applying for a specific season, please indicate that below.

WinterSpringSummerFall
References
1st Reference

First NameLast Name
Address of 1st Reference

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number of 1st Reference
Please enter a valid phone number.Format: (000) 000-0000.
Email of 1st Reference
example@example.com
Relationship (to you) of 1st Reference
Name of 2nd Reference

First NameLast Name
Address of 2nd Reference

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number of 2nd Reference
Please enter a valid phone number.Format: (000) 000-0000.
Email of 2nd Reference
example@example.com
Relationship (to you) of 2nd Reference
Name of 3rd Reference

First NameLast Name
Address of 3rd Reference

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number of 3rd Reference
Please enter a valid phone number.Format: (000) 000-0000.
Email of 3rd Reference
example@example.com
Relationship (to you) of 3rd Reference
Should be Empty:

Volunteer Application

References