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Volunteer Application

Contact Information
First Name *:
Last Name *:
Address *:
City *:
State *:
Zip:
Phone:
Email Address:
Military Veteran:
Are you currently employed?:
Demographics

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.

Date Of Birth *:
Gender *:
Pronoun:
Education:
Skills & Experience
Please list all skill and experience:
Availability

Please indicate the days and times you are usually available to volunteer.

Mornings
Afternoons
Emergency Contact

In the event of an emergency whom should we notify?

First Name:
Last Name:
Address:
City:
State:
Zip:
Phone:
Relationship:
References

Please list your current or most recent employer, if applicable.

Employer Name:
First Name:
Last Name:
Address:
City:
State:
Zip:
Phone:
Volunteer Opportunities & Interests
List all applicable volunteer skills you have:
Why are you interested in volunteering with Rainbow Hospice Care?:
Background Checks

It is policy of Rainbow Hospice Care to run background checks on all volunteers. If you have ever pleaded guilty to or been convicted of a felony or a misdemeanor (exclude minor traffic offenses), please describe in the text box below. Please explain when and where the offense occurred and describe your conduct. Sharing you have pleaded guilty to or been convicted of a felony or a misdemeanor (excluding minor traffic offenses) does not automatically disqualify you from becoming a volunteer.

I understand and agree that submitting this application form does not automatically register me as a Rainbow Hospice Care volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering. By submitting this form, I attest that the information I have provided on the form is true and accurate.

 

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