Maitri Volunteer Application

Volunteer Application

for Maitri Compassionate Care
- Name*
  
  First NameLast Name
- Email*
  example@example.com
- Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- Phone Number*
  
  Area CodePhone Number
- Your Birthdate*
  
  MonthDayYear
  Date
- Your Occupation*
- How did you hear about Maitri?*
  
  General / Word of mouthConversation with family, friends or colleaguesProfessional recommendationThrough a former resident or staff memberArticle, book or other publicationPrinted flierOnline searchOther
- What times on WEEKDAYS are you available?*
- Tell us about your volunteer interests and experiences
- How are you interested in helping out?*
  
  Emotional Support*Spiritual Support*Administrative Support*Cleaning / Maintenance*Transportation / Errands*KitchenFundraising EventsOther
- *Requires specialty training before beginning your volunteer work.
- What types of volunteer work have you done?*
- Have you participated in any hospice or other applicable training?*
  
  YesNo
- If "Yes," please elaborate:
- Do you have any special skill(s) you'd like to offer Maitri (e.g., body work, music, haircutting, art therapy, etc.)?*
  
  YesNo
- If "Yes," please describe:
- Are you able to meet the time commitment of four hours per week for six months?*
  
  YesNo
- If "No," please elaborate on your availability:
- Have you ever had a communicable disease that could now be a potential risk to a person with AIDS?*
  
  YesNo
- If "Yes," please describe:
- Do you have any condition(s) that puts you at risk for contracting a communicable disease?*
  
  YesNo
- If "Yes," please describe:
- In the last six months, have you experienced a major life change (e.g., death or other loss, change in job, living situation or relationship, etc.)?*
  
  YesNo
- If "Yes," please describe:
- Why do you want to volunteer at Maitri?*
- Describe your personal experiences with death, grief, and any feelings you may have about the grieving process.*
- Anything else you would like us to know?
- We appreciate the time and thought involved in completing this application. Thank you for your interest and support. If you have questions, please feel free to email our Volunteer Coordinator, David Valentine, at dvalentine@maitrisf.org.
- Should be Empty: