Please complete this application form if you are interested in becoming a Hospice of East Texas volunteer. Once you complete the form, click the Continue button at the bottom. The fields marked with an asterisk (*) are required fields.

Personal Information


Skills & Experience

What do you feel are your special skills, talents, or hobbies?


Volunteer Experience

Please list the agencies or areas where you have served as a volunteer.


Your Interest in Volunteering

Why would you like to volunteer for Hospice of East Texas?


References

Please provide the names of two references, who should not be related to you.


Emergency Contact

In the event of an emergency whom should we notify?


Employer

Please list your current or most recent employer, if applicable.


How did you hear about us?


Availability

Please indicate the times you are usually available to volunteer.


Background Check

If you have been convicted of crime, please state reason, charges and date of charge.


I Agree

Texas law permits obtaining record of convictions, deferred adjudications of felony charges and current offenses. I understand a criminal history check may be done.

By indicating my agreement below, I certify this information is true and correct to the best of my knowledge and I understand that any misrepresentation or willful omission of facts will be cause for rejection of this application or termination of my volunteer association. I hereby authorize The Hospice of East Texas to conduct personal reference checks, driving history and/or criminal conviction records to determine my acceptability for a volunteer position. I further agree to observe all rules, regulations and policies of The Hospice of East Texas.