Rehab Therapy Volunteer Application Form

Thank you for your interest! 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.

Saint Therese volunteers need to be 15 years old and able to commit to volunteering at least 30 hours for a minimum of one year.

We welcome Rehab students! One-time "shadow" opportunities for Rehab therapy students are often available at many of our locations. Please complete the application below and select your preferred locations.

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.

Schedule reminders
Handy reminders to help you remember when you're scheduled to volunteer.

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