Please complete this application form if you are interested in becoming a volunteer with Providence Hospice and Homecare of Snohomish County.

Fields with an asterisk next to them are required.

Personal Information


Availability

Please check all of the times that you are available to volunteer.


Areas of Interest

Please check the volunteer opportunities in which you are interested. You may check more than one.


Work/Education/Special Training

Please tell us about your current or previous work experience, education, or special training.


Personal Skills & Interests

What special services/skills or hobbies (art, music, languages, grant-writing, website design, public relations, hairdresser, etc.) do you feel you can incorporate into your hospice volunteer work?


Interest in Volunteering

How did you hear about us and why do you want to be a volunteer?


Prior Volunteer Experience

What prior experience do you have as a volunteer?


Experience with End of Life


Recent Bereavement

Have you experienced a significant loss within the last year? If so, please explain.


Requirements

All volunteers with Providence are required to attend training specific to their role, obtain a TB test (provided by Providence), etc. Volunteers must also be 21 years old or older. Volunteers must be able to commit to volunteering for 2-4 hours per week for a minimum of a year.


Background Checks

All volunteers must successfully pass a background check prior to beginning service with Providence.

Conviction of a crime will not necessarily be a bar to volunteer service. Factors such as type and nature of conviction(s) will be taken into account in determining effect on suitability for volunteering.


References

Please supply three references. If you have prior volunteer experience, please include one of your supervisors. References should be from people who have known you two years or longer.


Acknowledgment

I understand that I am applying for a position with Providence Hospice and Homecare of Snohomish County, an organization which provides hospice services and health care to individuals in their homes. I understand that the agency reserves the right to reject a volunteer candidate.

I consent to and authorize the agency and its personnel to ask any of the references I have listed for relevant information that may concern my performance as a volunteer for the agency. I therefore release all parties and persons connected with any request for information from all claims, liability and damages for whatever reason arising out of furnishing the information.

I certify that the information provided on this application is true and complete to the best of my knowledge. Furthermore, I agree to all background checks required by this agency.