Street Address Line 2
Are you 18 years of age or older?
Have you ever been convicted of a felony or misdemeanor?
If "Yes", please describe:
What type of volunteer services are you interested in providing:
Patient VisitsBereavement SupportLanguage SupportOutreach & TrainingOffice / Clerical AssistanceOther
If "Other", please specify:
List any relevant knowledge, skills, or competencies
Do you speak, write, or understand any foreign languages?
If "Yes", please specify:
Please describe the days and times you would like to volunteer.
Did you graduate?
Please specify Other Training:
WORK HISTORY - List any paid or volunteer work experience in the past 5 years, starting with your most recent employer. You may also attach an additional page or your resume.
Why do you want to be a Hospice Volunteer?
What are your thoughts and feelings about death and dying
Have you experienced a significant loss in the past 12 months?
Have you ever been with someone at the time of death?
Have you ever provided care to someone who is dying?
When thinking about your own death, what comes to mind?
I have read the Volunteer Code of Ethics and agree to abide by its regulations.