Volunteer Application

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Thank you for your interest in becoming a Seasons Hospice volunteer. Please complete the following information and submit it online or mail it to the Director of Volunteer Services, Seasons Hospice, 1811 Greenview Pl SW, Ste 110, Rochester MN 55902.

Personal Information
First Name		Middle Name
Last Name
Address
City	State	Zip Code
Day Phone #		Evening Phone #
Email Address
Are you presently employed? Full-time Part-time Retired No Student
Work experience (last two positions):
Are you 21 years or older? Yes No
How did you hear about this job?
Why are you interested in volunteering for Seasons Hospice?
What are your hobbies and special interests?
What talents/skills would you like to incorporate into your volunteer experience (computer skills, gardening, etc.)
Areas of volunteer interest (check all that apply)? Visiting pts/families Office assistance Grounds/gardens Bereavement Hospitality Special events Light cooking Fundraising Speakers bureau Other
Are you able to volunteer at least 4 hours per month? Yes No
When are you able to volunteer (check all that apply)? Weekdays Evenings Weekends Flexible schedule Seasonal Only (check all that apply): Winter Spring Summer Fall
Are you able to attend a three-day 21 hour volunteer training session during the daytime? Yes No
Do you have physical limitations? Please explain:
References
Name		Phone
Address		Relationship
Name		Phone
Address		Relationship
Name		Phone
Address		Relationship
The best way to contact me to arrange an interview and to complete the application process with the Director of Volunteer Services is: Email Day phone Cell phone
Signature			Date