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Volunteer Application
First Name
*
Last Name
*
Address
City
State
Zip
Phone
*
Email (we will keep your email completely private)
Add me to your email list!
Yes
No
Occupation
Emergency Contact Person (please include name and address)
What type of volunteer opportunity are you interested in?
Patient Care
Office/Administative
Special Events
Education and Special Training
Volunteer and Employment Experience
How did you learn about Old Colony Hospice?
Reasons for wanting to become a hospice volunteer
I am able to make the required 1 year commitment:
Yes
No
I have:
Transportation
Valid drivers license
Auto Insurance
There are physical limitations that would restrict me from fulfilling volunteer duties:
Yes
No
Message
List towns you are willing to cover (see service map)
When would you prefer to visit a patient?
Day
Evening
Weekend
Any
Patient care volunteers can specialize in several different areas. Please check any of the following specialties that are of interest to you:
Reiki
Rosary
Vigil
Pet Therapy
Music
Veterans
Other
References will be requested. Please note: Because Hospice Volunteers are faced with issues of death, dying, and bereavement, potential volunteers who are surviving family members are encouraged to wait a minimum of at least one year following a personal loss before serving as a patient-care volunteer.