Become a Volunteer

Please fill out the form if you are interested in becoming a volunteer.

You may also download the form in PDF format. (DOWNLOAD FORM HERE)

Volunteer

Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (home)
Phone (cel)
Email*
Enter Email Confirm Email
Emergency contact information (Primary)
Name
First Last
Relationship
Home #
Work #
Cel #
Emergency contact information (Secondary)
Name
First Last
Relationship
Home #
Work #
Cel #
May we contact you at work?
- Yes
- No
Voluteer Opportunities
Please feel free to check of more than one if you wish.
- Administration
- Fundraising
- Reception
- Bereavement Support
- Garden
- Housekeeping
- Complementary Therap
  (e.g. music, art, meditation, etc.)
- Kitchen
- Special Events
- Maintenance
- Community Visiting Hospic
  Services (30hrs Training Required)
- Residential Visiting Hospice
  Services (30hrs Training Required)
Work Experience and Education
Do you have volunteer experience?
- Yes
- No
If yes, where and in what capacity?
Please describe your education, skills and abilities that may be beneficial to our organization.
Language and Culture
Do you speak, write or read in any languages other than English?
- Yes
- No
Language spoken 1
Language ability_1
- Speak
- Read
- Write
Language spoken 2
Language ability_2
- Speak
- Read
- Write
Reason for Volunteering
Why would you like to volunteer for Maison McCullochHospice?
How did you learn about volunteering at Maison McCulloch Hospice?
Background Information
Have you had experience with the terminally ill?
- Yes
- No
Have you had a person close to you die within the last year?
- Yes
- No
Relationship
Do you have any allergies?
- Yes
- No
If yes, to what?
What is your availability?
Monday
- Morning
- Afternoon
- Evening
Tuesday
- Morning
- Afternoon
- Evening
Wednesday
- Morning
- Afternoon
- Evening
Thursday
- Morning
- Afternoon
- Evening
Friday
- Morning
- Afternoon
- Evening
Saturday
- Morning
- Afternoon
- Evening
Sunday
- Morning
- Afternoon
- Evening
References
Please provide two references other than family.
Name 1
Nature of relationship 1
Email 1*
Phone 1
Name 2
Email 2*
Phone 2
Nature of relationship 2
To maintain the integrity of our hospice and for the protection of our residents, a screening process will include an interview, contacting your two references and a criminal reference check.
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.

Volunteer

Emergency contact information (Primary)

Emergency contact information (Secondary)

Voluteer Opportunities

Work Experience and Education

Language and Culture

Reason for Volunteering

Background Information

What is your availability?

References