Volunteer Application Form
If you are interested in becoming a National Church Residences volunteer, please complete this application form. Once you complete the form, click the submit button at the bottom. Thank you.
North Fort Myers
Please provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers. If you do not feel comfortable submitting your birthday, type in today's date.
Please list your current or most recent employer, if applicable. Type "N/A" if this information is not applicable.
I am a Resident
Skills & Experience
What skills and talents do you possess that would useful in a volunteer setting?
Arts and crafts
Host a dinner/event
Socialization 1:1 and Group
What is your previous volunteer experience?
Please indicate the days and times you are available to volunteer.
Why are you interested in volunteering?
Please mark your preferred volunteer site. You may check more than one.
Bristol Village Health Care
Center for Senior Health - Dublin Granville
Chillicothe Health Care
Commons at Buckingham
Commons at Chantry
Commons at Garden Lake
Commons at Grant
Commons at Imperial
Commons at Livingston
Commons at Madeline Park
Commons at Third
First Community Village
Hospice of Central OH
Hospice of Southern OH
National Church Residences Central Office
Portage Trail Village
Water's Edge of Bradenton
Water's Edge of Lake Wales
Name of Affordable Housing location at which you are interested in serving.
In the event of an emergency, whom should we notify?
Please list a reference who is willing to speak on your behalf.
We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however we will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us. If you do not have an email address, simply type "firstname.lastname@example.org".
What kinds of email would you like to receive?
I recognize and acknowledge that by volunteering for National Church Residences and its affiliates in any capacity, there are certain risks involved, and I agree to assume all such risks including any damages resulting from physical injuries, death, loss of services or consortium, loss or damage to property or any other loss which I, or my child for whom I am the legal guardian, may sustain as a result of participating as a volunteer. I also understand that National Church Residences does not assume any responsibility for or obligation to provide financial or other assistance, including but not limited to medical, health, or disability insurance, in the event of injury, illness, death or property damage. I also certify that I am/my child is in the appropriate physical and mental condition to participate as a volunteer. I authorize National Church Residences, if reasonable attempts to contact me have been unsuccessful, to obtain any emergency medical attention for my child in the event of illness or an accident.
I understand that this Waiver and Release is intended to be as broad and inclusive as permitted by the laws of the UnitedStates, and if any portion of this is invalid, the remainder will continue in full legal force and effect. I have carefully read and voluntarily sign this Waiver and Release, and I fully agree and understand that its contents and meaning are a full waiver and release of all claims and liability against National Church Residences, its affiliates, and their respective employees, residents and volunteers.
I grant full permission to National Church Residences to use any photographs, videos, or recordings of myself, or my child or minor for whom I am the legal guardian, while volunteering for any purpose.
Volunteer Confidentiality Statement:
I agree to regard all information received in the performance of my volunteer work in this facility as confidential. I understand that this facility/community respects residents' rights with regard to privacy of information, and I agree to respect their rights in the performance of my volunteer duties and keep such information confidential outside of the facility.
I agree to respect each resident's right to privacy, as well as those of the family and the facility, whenever I make community presentations or participate in volunteer recruitment programs. The content of these presentations must be approved in advance by the Life Enrichment Director.
These are the basic expectations of professionalism and teamwork for volunteers of National Church Residences and its affiliates.
1. I will arrive at my scheduled volunteer shift on time and will complete my assigned duties.
2. I will notify the Volunteer Coordinator if I am unable to make my scheduled volunteer shift.
3. My appearance as well as my actions will be professional at all times. I am expected to wear business casual clothing and my name badge at all times.
4. I will sign in and sign out at the beginning and end of each volunteer shift.
5. I will report accidents, incidents and complaints to my Volunteer Supervisor as soon as they occur.
6. I will give my complete attention to the residents and clients of National Church Residences. I will not make personal phone calls or text during my volunteer shift.
7. I will not disclose any personal, health or other confidential information regarding this organization or its clients. Violation of this policy will result in removal from the volunteer program.
8. I will abide by the National Church Residences Code of Conduct. The Code of Conduct can be found at: https://www.nationalchurchresidences.org/pdf/code-of-conduct-2019.pdf
For more information you can watch our training video:
(Please watch video by copying link below to browser)
I acknowledge that National Church Residences holds me to the highest standard of resident and client care and that I am a part of this team because I reflect that commitment. I have read the above statements, agree to abide by the Code of Conduct, watched the Code of Conduct training video and understand that I will be held accountable to these along with all other policies of this organization.