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Advocate Hospice
Volunteer Profile
Back to How to Volunteer
___________________________________________________________________________
First and last name
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Address, Apartment number
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City, State, Zip Code
___________________________________________________________________________
Phone
___________________________________________________________________________
E-mail address
___________________________________________________________________________
Best Time to Contact You
Why are you seeking a volunteer position (check all that apply)
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Personal fulfillment |
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Professional Development |
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Family/Friend was a hospice patient |
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Extra Time |
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Requirement for class/degree |
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Possible future career |
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Other_________________________________
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| Have you experienced a recent loss or had a loved one in a hospice program? |
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Yes |
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No
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| Do you speak a second language? |
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Yes |
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No
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If yes, language (s)____________________________________________________
How did you learn about volunteering with Advocate Hospice?
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Friend |
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Employer |
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Instructor |
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Co-worker |
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Clergy |
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Doctor |
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Website |
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Newspaper |
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Poster/Flyer |
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Other____________________________________________
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Please list your previous work experience.
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_____________________________________________________________________________
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Type of volunteer work? (Check all that apply)
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Administrative/Clerical work |
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Patient/Family Care |
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Indirect patient contact |
Emergency Contact (Must be listed)
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Name of person to contact in an emergency
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Phone number of this person
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Relationship to you
Reference
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Name
___________________________________________________________________________
Phone
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Relationship to you
Please return this application via one of the following options:
Mail to:
Advocate Hospice
Volunteer Services
1441 Branding Ave., Suite 200
Downers Grove, Illinois 60515
Fax to 630.963.6877
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