Arbor Hospice Application

General Information

* Legal First name

Preferred First name

Middle name

* Legal Last name

Date of Birth

* E-mail for application status and subsequent communications

* Address Line 1

Address Line 2 (Apt., Condo, Suite)

* City

State

* Zip

* Preferred Phone

* Emergency contact name

* Emergency contact phone

Relationship to applicant

Volunteer Interests

Have you experienced the loss of someone close to you in the past 12 months?

We are so sorry for your loss. We require a 12 month waiting period following a close loss. Please reach out to us again after the waiting period.

It is our policy to require a one-year waiting period for volunteer applicants who have experienced the loss of a loved one. If someone close to you has died, we are very sorry for your loss. We recognize that you have a lot to offer as volunteer and we look forward to connecting with you after the waiting period.

Do you have previous hospice and/or hospice volunteer experience? What do you hope to gain from your volunteer experience? Please describe below.

Volunteering areas of interest

Working directly with patients

Working in the office (not with patients)

Grief support

Working on special events and fundraising events

Community outreach events and/or speaking in community

* Describe other skills and interests.

If you served in the military, please indicate which branch of service.

NO MILITARY EXPERIENCE

AIR FORCE

ARMY

COAST GUARD

MARINES

MERCHANT MARINE

NAVY

SPACE FORCE

If you'd like to upload your resume please do so here

Are you able to perform the functions of the volunteer role, with or without accommodations?

* How did you learn of volunteer opportunities at Arbor Hospice?

Providing an email address will expidite the onboarding process.

Criminal Background Check

Arbor Hospice regrets that an individual who has been convicted of a felony, or who has charges pending, is not eligible to volunteer. Misdemeanor convictions will be assessed according to our Criminal Background Check Policy (available upon request).

THIS IS A SECURE WEBSITE. YOUR ANSWERS ARE CONFIDENTIAL.

Have you ever filled a volunteer application with Arbor Hospice?

Application Submission

I certify that the facts in this application are true and complete to the best of my knowledge and understand that falsified statements on this application may result in termination as a volunteer. I understand and agree that my volunteering is for no definite period and may be terminated with or without cause, at any time, with or without notice. I also understand that I must complete volunteer training before being given an assignment. I am willing to participate in Arbor Hospice's ongoing in-service activities for volunteers. I certify that I am able to perform the essential duties of the volunteer position that I accept. In the event that I have a disability that will affect my ability to take an assignment, I will inform Arbor Hospice prior so that reasonable accommodations can be made. Arbor Hospice reserves the right to require medical documentation regarding the need for accommodation. I authorize investigation of all statements contained in this application. I release the listed references to provide you with any and all applicable information they may have. I hereby release these references from all liability for any information they may give to Arbor Hospice.

* Yes, I agree to the above statement.

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