Rehab Therapy Volunteer Application Form

Thank you for your interest in volunteering with Saint Therese! Volunteers play an essential role in enriching the lives of our residents. Saint Therese offers a wide variety of meaningful volunteer opportunities, flexible scheduling, family volunteer opportunities - and all training is provided.

During the coronavirus pandemic our volunteer opportunities are limited to remote support activities, such as sewing facemasks, creating isolation gowns, donations of activity supplies, cards and letters of encouragement to residents and staff, etc.

If you wish to get involved with remote assistance, please indicate that as your area of interest below and a member of the Volunteer Services team will contact you with more details on how to get started.

If your desire is to help with on-site and resident focused volunteer activities, please indicate so on your application and we will reach out to you when pandemic restrictions are lifted and on-site volunteer engagement resumes.

We are very grateful for your desire to help and will be in touch as soon as we are able!

Personal Information

First name:

Last name:

Middle name:

Nickname:

Street 1:

City:

State:

* Zip: *

Preferred phone:

Alternate phone:

Email address:

Date of birth:

* (year optional)

Employer name:

Why Saint Therese?

Why are you interested in volunteering with Saint Therese? What's motivating you? Do you have previous volunteer experience? It doesn't need to be senior-care related. We'd like to know more about you!

Preferred Location

What are your preferred locations to volunteer?

* Preferred Location:

Saint Therese at Oxbow (Brooklyn Park)

Saint Therese Foundation(St Louis Park)

Saint Therese of New Hope

Saint Therese of Woodbury

Saint Therse at St. Odilia(Shoreview)

TCU by Saint Therese (Robbinsdale)

Areas of interest

What are your areas of interest? Volunteer opportunities vary with location, so please indicate all that apply. We can't promise to match you up with your first choice, but we'll do our best!

Availability

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

We'd like to know...

References

Please provide us with a reference that we may contact. References should be adult, and NOT family members. A reference can be an employer, neighbor, co-worker, teacher, Scout leader, co-worker, youth group leader, coach, etc.

First name:

Last name:

Preferred phone number phone:

Work phone:

Alternate phone:

Email address:

Relationship:

Email Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however 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.

What kinds of email would you like to receive?

Volunteer News
Important news to keep you informed about Volunteer Services.

Saint Therese News
News about what's happening at Saint Therese.

Emergency Contact

Please let us know who to contact in case of an emergency.

First name:

Last name:

Preferred phone number phone:

Work phone:

Alternate phone:

Relationship:

Demographics

This information is voluntary, and is only used to help us understand the demographics of our volunteer program.

Education:

Ethnicity:

Gender Identity:

Next Steps

Thank you again for considering Saint Therese! Your application will be reviewed and you will be contacted by email for next steps. The response time may be up to two weeks during times of high application volume. We look forward to having you join our volunteer team!

Agreement statement

I agree to indemnify and hold harmless Saint Therese, its employees, volunteers or agents from any and all claims or causes of action that may arise out of performance of my duties as a volunteer. I also understand that I am participating in activities that have a potential risk of injury and waive Saint Therese of any liability. I agree that my name, photograph, or video image may be used for any reason by Saint Therese and their sponsors. This is a complete release, discharge and waiver of any and all actions or causes of action against the entities and persons set forth above and the offices, agents, employees, and volunteers of those entities.

I understand that as a condition of participation in this program that I may be required to provide the following: a Criminal Background Check, a Tuberculin Skin Test, reference checks, a Department of Motor Vehicles inspection card and a certificate of auto insurance. Failure to cooperate or unsatisfactory results may result in withdrawal of an offer to participate in this volunteer program.

I authorize Saint Therese to investigate all of the information contained in this application. Any persons or organizations named are authorized to provide information regarding my volunteer history, character, and qualification and they are hereby released from all liability for providing such information.

I understand that there will be an interview prior to being accepted as a Saint Therese volunteer and I will be expected to complete the required training for Saint Therese volunteers.

I Agree