Volunteer Application

Use this form to apply for volunteering with Serenity Hospice and Home.

"*" indicates required fields

Name*

First Last

Birthdate*

Street Address*

City*

State*

Zip Code*

Email Address

Home Phone

(If different from cell phone.)

Cell Phone

Occupation

Employer

Emergency Contact

First Last Phone

Person to be notified in case of emergency.

Are you interested in working at Angel Treasures Resale Shops only?

Yes

Are you interested in working at The Serenity Shed (bereavement center) only?

Yes

Hours Available (Monday-Wednesday)

Monday Tuesday Wednesday

Hours Available (Thursday-Saturday)

Thursday Friday Saturday

References: Please provide complete information as references are verified by mail.

Reference #1

Name Phone Address

Reference #2

Name Phone Address

Code Of Ethics

As a volunteer, I realize that I am subject to a code of ethics similar to that which binds the professional in the field in which I work. I, like them, assume certain responsibilities and expect to account for what I do in terms of what is expected of me.

I understand that any information that is disclosed to me while assisting the Serenity Hospice & Home is confidential and that this confidentiality is protected by the policies of the Serenity Hospice & Home.

I interpret “volunteer” to mean that I have agreed to work without compensation in money, but having been accepted as a volunteer worker, I expect to do my work according to standards set forth in the Volunteer Polices and Procedures. I accept this Code for the volunteer as my Code, to be followed with care and compassion.

Volunteer Application