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Online Volunteer Application Form
Volunteer Application Form
Please fill in the following application. Information provided will only be used by authorized Red Deer Hospice Society representatives to complete the volunteer screening process. Successful candidates will be required to provide a Criminal Record Check and Vulnerable Sector Check
Contact Information
Name
(Required)
First
Last
Home Phone Number *
(Required)
Alternate Phone Number
Occupational Status:
Employed/Self Employed
Student
Retired
Semi-Retired
Other
Email
Address
(Required)
Street Address
Address Line 2
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
What is the best time to reach you?
Morning
Day
Evening
May we contact you at your place of employment?
Yes
No
N/A
Emergency Contact Information
Emergency Contact *
(Required)
Phone Number
(Required)
Relationship
(Required)
Training, Experience and Skills
Please upload a resume or complete the Training, Experience and Skills sections.
Max. file size: 300 MB.
Training
Please list relevant training including formal education and other volunteer training courses.
Experience
Please list your experience and indicate if it was employment of volunteer.
Skills
Please list any licenses, certificates and special skills you are willing to use as a volunteer. (ex. First Aid, Drivers License, languages)
Availability
When are you typically available to volunteer? (Please check all that apply.)
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
Any holidays when you are available to volunteer:
Additional Questions
Why do you want to be a Hospice Volunteer?
What skills and interests will you bring as a Volunteer?
Do you have any physical or medical restrictions that may affect your function as a volunteer? Please describe so that we may select suitable roles.
For example: allergies, back, poor vision or hearing, etc.
What are your expectations of being a Hospice Volunteer?
Do you have experience working with people with life threatening illnesses? Please describe.
Have you experienced a significant personal loss? Please describe.
If yes, please include how long ago the loss occurred and what relationship the person was to you.
What hobbies, interests or activities do you enjoy?
Are you legally entitled to work/volunteer in Canada?
Yes
No
References
Please provide Name, Contact and Relationship information for two references.
Reference #1 | Name
(Required)
First
Last
Address
(Required)
Street Address
Address Line 2
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Email
(Required)
Phone
(Required)
Occupation
(Required)
Relationship
(Required)
Business
Personal
Family
Reference #2 | Name
(Required)
First
Last
Address
(Required)
Street Address
Address Line 2
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Email
(Required)
Phone
(Required)
Occupation
(Required)
Relationship
(Required)
Business
Personal
Family
You must read and agree to the following before submitting your application: 1. I understand that the information provided in this application to volunteer with the Red Deer Hospice Society is part of the volunteer permanent file at the Society's office. It will be kept confidential and only be used to assist in completing the volunteer screening process and in matching me with Hospice Clients. 2. I understand that if I am accepted as a Volunteer with the Red Deer Hospice Society, I am committing to attending education and training sessions for volunteers provided by the Society. Please note: completion of training does not guarantee continued volunteer involvement in a client-related capacity. 3. I agree to abide by the Policies and Norms of Practice of the Red Deer Hospice Society. 4. I hereby certify that all information included in this application is true and complete. I give permission for an Authorized Society representative to conduct reference checks with the above named referees and release the Red Deer Hospice Society and all others from liability in connection with the same.
Agreement of Terms
(Required)
I have read and agree to the above terms.
Comments
This field is for validation purposes and should be left unchanged.
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