Please complete this application form if you would like to become a volunteer Lay Chaplain at Headwaters Health Care Centre. Once you complete the form, click the Continue button at the bottom.

Your Personal Information

Please provide the following information. * indicates a required field.


Faith Community Name


How long with this Faith Community?


Why do you want to volunteer for this position?

Tell us what led you to apply and the life experiences that have prepared you.


What gifts do you bring to this position?

Tell us about your gifts, talents and skills.


Why do you think spiritual care is important?

Please reflect on the role of spiritual care in the hospital experience.


Describe any previous volunteer experience.


How did you hear about this opportunity?


Are you comfortable in a multi faith environment?

Do you feel you can provide spiritual care to individuals with different beliefs than yourself?


Check ONLY if you agree with ALL statements.

I can obtain a criminal background check.
I have previously read the role description and believe that I meet the qualifications.
The information I have provided is true and complete.
I understand that this information will remain confidential and is the property of Headwaters. It will be destroyed if I do not become a Volunteer Chaplain.
I understand that not all applicants will necessarily be accepted into the Volunteer Chaplaincy Program. I will be advised at each step if I will advance in the process.
I understand the need to comply with infection control guidelines when serving in the hospital. (No hand and arm jewellery other than plain wedding band. No false nails, gel nails or polish).
I understand that Headwaters is a no scent facility and will be governed accordingly.
I understand that the cost for vaccinations/police checks/and health forms which may be requested are my responsibility.
I understand that volunteer chaplains work in an environment that respects diversity.