Volunteer Application | Richmond County Hospice

First name

Last name

Date of birth

Country

Address line 1

Address line 2 (optional)

City

State

ZIP code

Email address

Phone number

Message

Employer (optional)

Occupation (optional)

First name

Last name

Relationship to you

Emergency contact number

Marital status

Do you have children?

High school attended (optional)

College attended (optional)

Other special training (optional)

Are you currently in school? (optional)

In Home Patient/Family CareSitter ServiceNursing HomeHospice Admin BuildingHospice HavenReading/Writing LettersBereavement Phone CallsBereavement Home VisitsBereavement Office/Clerical WorkSupport Group Co-FacilitatorLight of Life CommitteeAdministrative HelpFundraisingMailingsSpecial EventsData EntryYard MaintenanceMoving Equipment/SuppliesPaintingOther

How would you describe your general health? (optional)

Do you read, write or speak another language? (optional)

If so, which languages?

How did you hear about hospice volunteering?

Why do you want to volunteer?

What skills or talents will make you a good volunteer?

What are your thoughts about death?

Have you ever been with someone at the time of their passing? (optional)

If so, please describe briefly.