Volunteer Application

Thank you for your interest in volunteering with St. Joseph’s Hospice! We invite you to join us and share your time, skills and experience to a great cause. Please complete the application below. Once completed, you will receive a phone call or email from Volunteer Services within 1-2 weeks.

18 years or older (required)


Gender (required)


Address

Emergency Contact

Work Experience

Highest level of education attained


Volunteer Experience

Volunteer Positions

Please check all that apply


When are you available to volunteer? (write all that apply)

Please specify a start and end time.


General Information

St. Joseph's Hospice serves individuals from diverse backgrounds. Do you speak any other languages other than English?


If yes, please indicate languages:

The work of St. Joseph's Hospice occurs in a variety of settings with varying levels of supervision. The work may also involve light to moderate physical activity. Do you have any medical conditions of which St. Joseph's Hospice should be aware?


In-Home & Transportation

Are you comfortable volunteering in a smoking environment?


Are you comfortable volunteering in a home with pets?


For positions involving driving clients, the following requirements are expected:


A valid Ontario Driver's License


Access to a vehicle with a minimum of $1 million liability insurance


A signed statement indicating there are no outstanding breaches of the Highway Traffic Act


For Complementary Therapists, Estheticians & Hair Stylists Only

In which of the following areas are you able to volunteer? (check all that apply)


Criminal Reference Check and Vulnerable Position Screening

All prospective St. Joseph's Hospice volunteers must complete a Criminal Reference Check and Vulnerable Position Screening. You must submit the completed check before being accepted into the Hospice Volunteer Training Program.

Are you willing to have a police check?


Do you have any criminal convictions for which you have not received a pardon?


Personal Experiences

Do you have experience with the terminally ill?


Have you had a person close to you die within the last year?


Stress Management

Waiver Agreement

I understand that the information provided in this application to volunteer with St. Joseph's Hospice is part of a permanent volunteer file and is only available to St. Joseph's Hospice staff. The information will be used to complete the volunteer screening process. I certify that all the statements made on this form are true, complete, and correct. I authorize St. Joseph's Hospice to contact the references I have provided. I understand that any false information on this application will be cause for termination as a volunteer.

Volunteer References

As part of the screening process to become a Hospice Volunteer, we ask you to provide 2-3 character references. These references are to be a combination of personal (other than relatives) and professional associations from individuals over 18 years of age who you have known for over 2 years.

Reference # 1

Reference # 2

Reference # 3

Permission

I give my permission to the Coordinator of Volunteers, or designate, to contact these individuals by mail, telephone, fax or e-mail (required).