Volunteer

Volunteer Application

Step 1

Personal Information

indicates a required field




Desired Contact Method


Step 2

Education & Training

indicates a required field


Elementary School

Did you graduate?


High School

Did you graduate?


College

Did you graduate?


Other

Did you graduate?


Step 3

Employment History

indicates a required field


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.

Company

Employed From

To


Company

Employed From

To


Company

Employed From

To


Are you related to any current employee, volunteer, or board member at Hospice & Palliative Care of Iredell County?


Step 4

Volunteer History

indicates a required field


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

Organization

Employed From

To


Organization

Employed From

To


Organization

Employed From

To


Step 5

References

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


Reference 1


Reference 2


Reference 3


Step 6

Volunteer Interests

indicates a required field


To assist us in securing a proper assignment for you, please check any of the following areas that interest you as a volunteer.

Have you recently (within last 12 months) experienced the death of a family member or close friend?

If Yes, please specify.

Do you drive?

Do you have a vehicle at your disposal?

Do you have any of the following special skills or hobbies? Check all that apply.


How much time do you feel you will be able to contribute to Hospice?




Step 7

Optional Information


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

Emergency Contact




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?*

If Yes, please describe in full.


Receive Updates

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

Statesville Office

2347 Simonton Road
Statesville, NC 28625
Phone: 704-873-4719
Map & Directions

Mooresville Office

1325 Mecklenburg Highway
Mooresville, NC 28115
Phone: 704-663-0051
Map & Directions