A- 1 Volunteer Application

Thank you for your interest in volunteering with Treasure Coast Hospice. If you are under the age of 18, do NOT fill out this application. Please click HERE instead.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you reside in a Gated or 55+ Community?*
Name of Community*
Please Type N/A if the answer is NO
Email*
example@example.com
Phone Number*

Area CodePhone Number
Birth Date*

MonthDayYear
Date
Birthday (DO NOT DELETE)*
Ethnicity *
Calls to my home phone numberCalls to my cell phone numberText to my cell phone numberEmail to my listed email
Martin CountySt Lucie CountyOkeechobee CountyFlexible (will travel within reason)Other
Next available in-person session at 5000 Dunn Road, Ft. Pierce, Florida 34987. Session runs from 8:30 AM to 3:00 PM.I prefer to complete my orientation online (available for non-patient visitors).I have attended a Treasure Coast Hospice orientation within the last 6 months. Please contact me with next steps.
Please provide two personal references - name and phone number.
Reference #1 - Name*
Reference #1 - Phone*
Reference #1 - Number of years you have known the reference named above?*
Reference #1 - Relationship to volunteer?*
Reference #2 - Name*
Reference #2 - Phone*
Reference #2 - Number of years you have known the reference named above?*
Reference #2 - Relationship to volunteer?*
Describe any relevant professional or work experience you have.*
YesNoI would like more information about this.
YesNoI would like more information about this.
ArmyNavyAir ForceMarinesNational GuardI did not serve in the militaryReservesOther
As neededSeasonally - winter monthsSeasonally - summer months
MondayFridayTuesdaySaturdayWednesdaySundayThursdayHolidays
8 AM - 12 PM12 PM - 4 PM4 PM - 8 PM
YesOther
YesNoWould like to learn more
Patient Visitor - Visit with patients in their home, Facility, or IPU (In-Patient Unit). Activities may include reading, playing cards or games with the patient, leading a simple craft, or simply being present to sit or listen during your visit.Telephone visits/ Comfort Calls – Calling the patient once a week to say hello. Your phone visits may be with the Patient or the Caregiver. Either may need to have a conversation. Your smile will come through the phone and lift their spirits.Office/Front Desk Support - Various locations-filing, phone calls, data entry and patient packet assembly.Pen Pal – Brighten the day of patients in facilities by sending a handwritten note card with a warm and friendly, "Hello, we're thinking of you!" Cards and envelopes are provided for you.Veterans-to-Veterans Program - Talk to veteran patients one-on-one about their experiences in the military, or just be a friendly face or ear as a fellow veteran. Also provide special pinning ceremonies to honor patients' military service for those who wish to be recognized.Helping Hands -Do you enjoy sewing, knitting or crochet? We have opportunities for volunteers to make blankets, quilts and memory bears.Thrift Store - Do you enjoy the retail environment? We have opportunities for volunteers as Cashier, Merchandise Sorter, and Customer Service.Treasure Coast Hospice Events or Community Events - hand out printed material, serve in various roles or helping with special events.Kitchen IPU (In-Patient Unit) -Do you enjoy kitchen work? We have opportunities to support our dietitian in our IPU Kitchen assisting with patient meals and various kitchen tasks.Treasured Pets - Pet Friendly - Assist with the care of the patients' pets by dog walking, transporting to vet or grooming visits, and delivery of pet supplies.HosPet - Volunteer with your certified therapy dog to bring a smile as you and your dog visit patients.I am not sure and would like more information before deciding.Virtual Reality - This is an exciting technology that allows patients and their families to visit far-away places or experience an unfulfilled wish. Experiences help prompt memory recall and increase interaction between patients, caregivers, and their families. Training is provided.Legacy Project - Are you great at writing, gathering photos and interviewing? You can provide a priceless keepsake for patients and their families by walking them through a questionnaire about their history (military, family, or other), gathering photos and presenting it to them as a finished piece (tools and training will be provided).Other
ReadingPlaying Cards or GamesSewingPhotographyJournalingQuiltingCreative WritingCookingKnittingCrochetingGardeningSportsCraftingPuzzlesPublic speaking or presentingEvent/Party PlanningOther
Piano, organ, or other keyboard instrumentGuitar, Violin, or other string instrumentTrumpet, saxophone or other horn InstrumentI do not play any instrument or singSinging with a group or soloOther
WordExcelPowerPointCanvaData EntryNo Computer SkillsOther
American Sign LanguageSpanishFrenchItalianCreoleGermanPortugeseI do not speak a second languageOther
YesNo
If you answered "Yes" to the above question, please answer the following:
Hospice Name and Location
Dates of Volunteer Service

MonthDayYear
Date
I have volunteered with other (non-hospice) organizations. Please list organization names or enter "none" below.*
VolunteerMatchVolunteerFloridaSocial MediaNewspaper AdGoogle SearchAnother Treasure Coast Hospice volunteerTreasure Coast Hospice employee (list name under "Other")I had a personal loss who was a patient of Treasure Coast HospiceI previously worked in the medical fieldOther
I am interested in volunteering at this time in my life because? Please share your thoughts.*
Please share your thoughts as to why you selected Treasure Coast Hospice to volunteer.*
Make new friendsFill my timeGive back or support the missionUse my experience and skillsFind job opportunitiesHelp othersOther
YesNo
YesNo
Employed - Part TimeStudent - High SchoolEmployed - Full timeStudent - CollegeUnemployed and not looking for workRetiredUnemployed and looking for work
YesNo
Thank you for completing your application to volunteer with Treasure Coast Hospice. If you did not choose to speak with a member of our Volunteer Services Team, our HR representative will be in touch.
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