Become a Volunteer

First Name:
Last Name:
Address:
City:
State:
Zip Code:
Home Phone:
Work Phone:
Cell Phone:
Email Address:
Employer:
Employer Address:
Employer City:
Employer State:
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Sun Mon Tue Wed Thu Fri Sat Morning Afternoon Evening
Aromatherapy Healing Touch Energy (Reiki, etc) Pastoral Social Administrative / Clerical Art Therapy Fund Raising Education / Outreach Hair Styling / Barber Music Therapy Reflexology Maintenance / Home Repair Gift Shop Message Pet Therapy Transition Team Audio / Video
References: Please provide us with three references.
Reference #1:
Full Name:
Relationship:
Address:
City:
State:
Zip Code:
Daytime Phone:
Evening Phone:
Reference #2:
Full Name:
Relationship:
Address:
City:
State:
Zip Code:
Daytime Phone:
Evening Phone:
Reference #3:
Full Name:
Relationship:
Address:
City:
State:
Zip Code:
Daytime Phone:
Evening Phone:
Previous Volunteer Experience: Please tell us about your previous volunteer experience. How long were you with the organization? Why did you leave?
Work / Education / Special Training: Please tell us about your previous work experience, education, or special training.
Interest in Volunteering: How did you hear about us and why do you want to be a hospice volunteer?
Personal Qualities: What special services / skills or hobbies (art, music, languages, grant-writing, website design, public relations, hairdresser,etc) do you feel you can incorporate into your hospice volunteer work?
Service Commitment: Is there anything that would prevent you from making a commitment to volunteering 3 hour per week for a minimum of 1 year?
Views on Death and Dying: What are your thoughts and feelings about death?
Previous Experience with Death and Dying: Have you ever been with someone around the time of death or provided care to someone who was dying? If yes, please describe briefly.
Recent Bereavement: Have you experienced a significant loss within the last year? If so, please explain.
Applicant's Certification and Agreement: By submitting this application, you certify to the following: I certify that all information provided in this volunteer application is true and complete. I understand that any false information of omission may disqualify me from further consideration from volunteering and may result in my dismissal at a later date. I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employer, and organization to provide relevant information and opinions that may be useful in making a decision. I release such persons and organizations from any liability in making such statements. The Hospice of Saint John does not discriminate in volunteer opportunities on the basis of race, disability, color, creed, religion, gender, age, marital status, sexual orientation, gender variance, national origin, ancestry, citizenship, veteran status, or any other protected classification. All volunteers are subject to a background test and must pass a drug screening.

A 501(c)(3) nonprofit organization

303-232-7900


1320 Everett Court
Lakewood, Colorado 80215



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Winner of 3 prestigious International Silver Davey Awards for 2010, by the International Academy of Visual Arts

Winner of 2 prestigious International Gold MarCom Awards for 2010, by the Association of Marketing and Communication Professionals

Winner of the prestigious International Platinum MarCom Awards for 2009, by the Association of Marketing and Communication Professionals

Winner of the prestigious International Gold MarCom Awards for 2009, by the Association of Marketing and Communication Professionals