Bobby’s Hospice - Volunteer Application

Full Name
Full Name
Full Address
Full Address
Email Address
Email Address
Phone Number

Phone NumberPhone Number
Current Work Status
Current Work Status
Please select the positions you would like to volunteer for:
Please select the positions you would like to volunteer for.

Patient & Family SupportGrief & Bereavement SupportFood ServicesAdministrative SupportFundraising & Special EventsThe Hospice Shoppe
Do you have previous work experience (volunteer or paid) or training?

YesNo
If Yes, please describe.
If Yes, please describe.
Why do you want to be a Hospice volunteer?
Why do you want to be a Hospice volunteer?
What do you view as the strengths you bring to this work?
What do you view as the strengths you bring to this work?
Do you have any physical or medical restrictions/conditions that may affect your function as a Hospice Volunteer? (i.e. allergies, back, poor vision, or hearing, etc.)

YesNo
If Yes, please describe.
If Yes, please describe.
Do you feel you are ready to help others deal with death and dying, and/or support our work?

YesNo
If Yes, please describe.
If Yes, please describe.
Availability: Please checkmark how much you can regularly devote to the Hospice.
Availability: Please checkmark how much you can regularly devote to the Hospice.

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Availability 2

1/2 Days - Morning (8-12)1/2 Days - Afternoon (12-4)Evenings (4-8pm)Occasional/On Call
Please provide two references – preferably one personal and one professional reference from previous employment or volunteer work (NO FAMILY MEMBERS OR RELATIVES)
Reference 1
Reference 1 Full Name
Full Name
Reference 2 Phone Number

Phone NumberPhone Number
Reference 1 Relationship
Relationship
Reference 2
Reference 2 Full Name
Full Name
Reference 2 Phone Number

Phone NumberPhone Number
Reference 2 Relationship
Relationship
Should be Empty:

Please select the positions you would like to volunteer for:

Availability: Please checkmark how much you can regularly devote to the Hospice.

Reference 1

Reference 2