Get Involved with Hospice & Palliative Care of Iredell County

Volunteer Application

The definition of a volunteer: one who enters into or offers himself for a service of his own free will. Whether a Hospice & Palliative Care of Iredell County volunteer chooses to hold a pen or a hand, they give the most precious gift of all – time.

Donate

Help us continue serving our community with compassion, comfort and dignity.

 

Volunteer

Make a powerful impact on the lives of your neighbors in their time of greatest need.

 

Receive Updates

Receive the latest news about upcoming events, volunteer opportunities and more.

Personal Information
* Required Information
 
Desired Contact Method:*
  • Home
  • Business
  • Cell
  •  
  • Email

 

Education and Training
* Required Information
 
Elementary School
  • Yes
  •  
  • No
High School
  • Yes
  •  
  • No
College
  • Yes
  •  
  • No
Other
  • Yes
  •  
  • No

 

Employment History
* Required Information
 

Start with your present or most recent employer. Give accurate, complete information accounting for all periods of time including military service and any periods of unemployment. Please give month and year.

Duties Performed:*

 

Duties Performed:

 

Duties Performed:

 

Volunteer History
* Required Information
 

Please list your volunteer service with any other organization/agency. (Please include church service if applicable).

Duties Performed:*

 

Duties Performed:

 

Duties Performed:

 

References
* Required Information

Give three references listing name, address, phone number, and occupation. Do not list relatives or former employers.

 

 

 

Volunteer Interests
* Required Information
To assist us in securing a proper assignment for you, please check any of the following areas that interest you as a volunteer.
  • Office/Clerical
  •  
  • Direct Patient Care
  •  
  • Maintenance
  • Board of Directors
  •  
  • Organization Comittees
  •  
  • Special Projects
  • Public Speaking
  •  
  • Errands
  •  
  • Fundraising Events
  • Health Fairs
  •  
  • Bereavement Support
  •  
  • Memorial Service
  • Telephoning
  •  
  • Marketing
  •  
  • Other: 
Have you recently (within last 12 months) experienced the death of a family member or close friend? *
  • Yes
  •  
  • No
If Yes, please specify.
Do you drive?*
  • Yes
  •  
  • No
Do you have a vehicle at your disposal?*
  • Yes
  •  
  • No
Do you have any of the following special skills or hobbies? Check all that apply.
  • Nursing
  •  
  • Public Speaking
  •  
  • Musician
  • Pet Therapy
  •  
  • Massage Therapy
  •  
  • Art Therapy
  • Cooking
  •  
  • Foreign Language
  •  
  • Computers
  • Hobbies
  •  
  • Other: 
per:*
  • Week
  •  
  • Month

 

Optional Information
Do you have any physical limitations that might affect your volunteering?

 

Emergency Contact
* Required Information
HOIC does require criminal background checks on volunteers. Have you ever been convicted of a crime, excluding misdemeanors and summary offenses, in the past seven (7) years that has not been annulled or expunged or sealed by a court?*
  • Yes
  •  
  • No
If Yes, please describe in full.
  • I certify that to the best of my knowledge, the information contained in this application is true and correct.*