Adult Volunteer Application Form
Please complete this application form if you are interested in becoming a Banner Homecare and Hospice volunteer. Once you complete the form, check the I Agree box and click the Continue button at the bottom.
NAME AND ADDRESS
You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.
Do you have any physical or medical conditions that may limit your ability to perform volunteer duties? If yes, please explain:
IN CASE OF EMERGENCY
Are you employed? By who? Please tell us about your previous volunteer experience. What are your hobbies or special skills? Are you currently enrolled in school? Where? What are your areas of study?
SERVICE WITH BANNER
Have you worked for Banner or volunteered for Banner before? If so, when and where?
WHY DO YOU WISH TO VOLUNTEER?
Please explain why you would like to volunteer:
During which months, days and hours are you available for volunteer assignments?
Is there anything else you would like us to know?
VOLUNTEER COMMITMENT TO SERVICE & CONFIDENTIALITY
Believing that Banner Homecare & Hospice has a genuine need for my services as a volunteer, I agree to:
(1) Maintain confidentiality of all information which I may obtain directly or indirectly concerning patients, physicians, or personnel;
(2) Provide excellent volunteer service. I understand that my services are donated to Banner Homecare & Hospice and that I will receive no compensation or promise of future employment;
(3) I verify the information on this application is true. I understand that I will be required to complete an orientation, health screening, and criminal background check.
I understand that this is a voluntary service. By signing below, I accept and agree to comply with the policies, rules, and regulations of the Banner Homecare and Hospice Volunteer Services Department.
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