Hospice Volunteer Application

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About You

Telephone(Required)

Alternate Telephone

What language(s) do you speak?

English, French, Italian, Spanish, Polish, Hindi/Urdu, Arabic, Portuguese, Japanese, Mandarin, Russian, ASL (American Sign Language)

Your Volunteering Experience

If yes, where?

Please tell us why you would like to volunteer at Hospice :

Please describe any past volunteer work you may have done and where:

If yes, please describe your experience:

If yes, please attach a scan of your certificate:

Max. file size: 64 MB.

Availability

Please check all that apply:

Areas of Interest

Please check all that apply:

If "other" please describe:

References

Please list 2 personal references (excluding family members):

Email

Phone

Email

Phone

Vulnerable Sector

We require you to get a vulnerable sector police check (valid within the last 6 months).

If "yes" please explain:

Confirmation

By checking this box and submitting this form, you affix your electronic signature and certify that this application was completed by the person applying for a volunteer position at and that all information entered on it is true and completed to the best of your knowledge. You also authorize Hospice Cornwall to check the references that you have provided.

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