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Present or Most Recent Volunteer Experience

Volunteers are placed in a regular weekly assignment. Some volunteer assignments are available seven days a week, early morning through late evening. Indicate the day(s) of the week you are available to volunteer. If you are flexible in the days/times you can volunteer, place a check in any of the boxes based on your availability. This information will help us determine the possible position openings that may be of interest to you when you meet with the volunteer coordinator.

Volunteer Shift Start Time

Please select the type of role(s) you are most interested in
Emergency Contact Information
Reference Information - Please list three individuals who have known you longer than one year and are not related to you.

The information provided on this application is true and complete to the best of my knowledge. I agree to have any of the statements verified by Cleveland Clinic Hospice. I understand that providing any false or misleading information or any omission may disqualify me from further consideration as a volunteer and may result in my immediate termination, even if discovered at a later date. I authorize representatives of Cleveland Clinic Hospice to conduct a thorough investigation of all my activities, and authorize all references provided in this application to provide all information they have about me. I can fulfill the minimum volunteer requirement of two (2) hours per week/ eight (8) hours per month.

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Background Information Release: