Reliance Hospice & Palliative Care | Volunteer Application
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Volunteer Application

Volunteer Application

To become a Volunteer, please fill out the form below and click on the SUBMIT at the bottom when finished.

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Emergency Contact

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EDUCATION & 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.

REFERENCES (Excluding Family Members)

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Code of Ethics
As a Hospice Volunteer, I am subject to a code of ethics similar to that which binds the professionals in the field of end-of-life care. As such, I assume certain responsibilities and expect to account what is expected of me. I understand that any information that is disclosed to me while assisting the hospice is confidential. I interpret "volunteering" to mean that I have agreed to work without monetary compensation. Having been accepted as a volunteer, I expect to do my work according to the standards set forth in the Volunteer Policies and Procedures.


Declaration
I hearby certify that the statements made on this application are true and accurate to the best of my knowledge. I understand that, by submitting this application, I authorize inquiries to be made concerning my employment, character, and public records for the purpose of determining my suitability as a volunteer. I affirm that I have read the Volunteer Code of Ethics and agree to abide by its regulations. I agree to respect the confidentiality of any client information I may acquire in the course of my volunteer activities.