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Volunteer Application

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This form has been designed for Good Shepherd Hospice, and therefore some of the questions may seem a little personal.  However, the information sought is the most helpful in placing you with the appropriate patient/family.  The information you provide below is strictly confidential.

How do you prefer to be contacted? *
Are you over the age of 18? *
Are you working?
If yes,
Do you know a language other than English?
Choose all that apply:
Have you ever been with someone at the time of their death?
Please check off the days of the week that you would be able to attend the training course. *
References
Please provide two references (excluding family members) who can attest to your character and ability to perform as a hospice volunteer.
I understand and am prepared to make a one year commitment of 3 hours per week to this volunteer opportunity. *
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