Please complete this application form if you are interested in becoming a Novant Health Hospice volunteer. Once you complete the form, click the submit button at the bottom.

Contact Information

Please fill out the following, to help us get to know you better.


Demographics

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.


Skills & Experience

What skills can you bring to Novant Health Hospice as a volunteer?


Availability

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


Assignment Preference


Emergency Contact

In the event of an emergency whom should we notify?


References

Please provide two references, under number one and two. ( Please do not include family members as a reference)


Email

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email. Please provide your email below so we can keep you informed of current volunteer needs.


Previous Volunteer History

Please list all previous volunteer history


How did you learn about Hospice?


Why do you want to become a hospice volunteer?


I Agree

I understand and agree that submitting this application form does not automatically register me as a Novant Health Hospice volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.
By submitting this form, I attest that the information I have provided on the form is true and accurate.